Multi-indication and Combination Pricing and Reimbursement of Pharmaceuticals: Opportunities for Improved Health Care through Faster Uptake of New Innovations.
Appl Health Econ Health Policy
; 16(2): 157-165, 2018 04.
Article
en En
| MEDLINE
| ID: mdl-29470774
ABSTRACT
Many pharmaceuticals are effective in multiple indications and the degree of effectiveness may differ. A product-based pricing and reimbursement system with a single price per product is insufficient to reflect the variable values between different indications. The objective of this article is to present examples of actual pricing and reimbursement decisions using current value-based pricing in Sweden and to discuss their implications and possible solutions. The value of several cancer drugs was estimated for various indications based on a willingness-to-pay threshold of 1 million SEK (EUR 104,000) per QALY gained. For some drugs, the estimated value was higher than the drug acquisition cost in several indications, whilst in others, the estimated value was lower than the drug acquisition cost. Drugs used in combination present a special case. If a drug prolongs survival and consequently also a continued use of the anchor drug, the combination use may not be cost effective even at a zero price. In a product-based pricing and reimbursement system, patients may not get access to drugs or access may be delayed and manufacturers may be discouraged to invest in future indications. To overcome these issues, there are several approaches to link price and value. One approach is a "weighted-average" price based on an average of the value across all indications. Another is "multi-indication pricing," which enables price differentiation between indications. However, there are several barriers for applying multi-indication pricing and reimbursement schemes. One barrier is the lack of existing administrative infrastructure to track patients' indications.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Mecanismo de Reembolso
/
Costos de los Medicamentos
/
Terapias en Investigación
/
Quimioterapia Combinada
/
Mejoramiento de la Calidad
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
Aspecto:
Implementation_research
/
Patient_preference
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Appl Health Econ Health Policy
Asunto de la revista:
SAUDE PUBLICA
/
SERVICOS DE SAUDE
Año:
2018
Tipo del documento:
Article
País de afiliación:
Suecia