Pricing and Reimbursement

Value-based pricing (VBP) is an efficient method for pricing new drugs. Rate of return pricing could, however, be useful in two cases: treatments for ultra-rare diseases, and ‘cures’ for conditions currently being treated at great expense. Rate of return pricing gives rise to challenges. Two are (i) finding proxy estimates of development costs including failures, and (ii) driving future research towards discovering high-value treatments.

The Japanese government has recently announced new plans to implement HTA from April 2019. The ISPOR HTA Task Force published ‘Good Practices in HTA’ in January 2019. The Japanese proposals do not meet them.

The combination of rising drug costs in the US and increasing financial stress for individual patients has triggered intense national concern. One target has come under particular scrutiny: rebates. A new report published by ICER and the OHE describes how alternatives to the current rebate system offer potential disadvantages as well as potential benefits. It outlines evidence presented to date and key questions that still need to be answered.

Making Outcome-based payments a reality in the NHS authored by The Office of Health Economics, RAND Europe, King’s College London, and Cancer Research UK, and commissioned by Cancer Research UK in partnership with Greater Manchester Health & Social Care Partnership, explores alternative pricing models and the implications of outcome-based payment schemes for improving access to cost-effective cancer drugs.

Two articles, published in the Journal of Comparative Effectiveness Research, explore the use of real-world evidence for coverage and formulary decisions.

Multi-Indication Pricing: Practical Solutions and Steps to Move Forward. A summary of an HTAi panel session.

OHE staff recently attended the ISPOR Europe conference in Barcelona. In this blog post, we share a selection of our presentations.

OHE Lunchtime Seminar with Dr. Aslam Anis, The University of British Columbia. The seminar will discuss the impact of the pan-Canadian Pharmaceutical Alliance “tiered pricing” framework (a flexible 'price-cap' regulation) on generic entry, the resulting drug expenditure levels from a drug plans’ perspective and the implications of price-capping policies on drug shortages.

OHE Lunchtime Seminar with Dr. Aslam Anis, The University of British Columbia. The seminar will discuss the impact of the pan-Canadian Pharmaceutical Alliance “tiered pricing” framework (a flexible 'price-cap' regulation) on generic entry, the resulting drug expenditure levels from a drug plans’ perspective and the implications of price-capping policies on drug shortages.

OHE presented at the ISPOR Summit on New Approaches to Value Assessment: Towards More Informed Pricing in Healthcare, held October 2018.

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