Pricing and Reimbursement

At the 13th Annual Conference of the Institute of Healthcare Management, Scotland, Jon Sussex discussed OHE’s model for projecting the UK NHS medicines bill to 2014 and a range of projections from it.

This post reviews OHE's activities in September 2011 that contributed to advancing thought and stimulating innovative ideas in its three key research areas: financing and delivery of health care, HTA methods and processes, and the economics of the pharmaceutical and life sciences industries.

Join OHE at ISPOR to discuss multiple criteria decision analysis, value based pricing, risk sharing, post-approval data collection and other key topics in HTA and health care decision making.

At the PPRI conference in Vienna on 29-30 September, 2011, Jorge Mestre-Ferrandiz presented a poster summarising the results of a literature review on risk sharing, flexible pricing, patient access schemes and performance-based reimbursement.

This is the first in a series of posts that will review OHE’s contributions to advancing thought and stimulating innovative ideas in its three key research areas: financing and delivery of health care, HTA methods and processes, and the economics of the pharmaceutical and life sciences industries.

The August 2011 issue of Health Affairs featured four articles on how and why pricing for pharmaceuticals differs from one country to another. The OHE’s Prof Adrian Towse co-authored the lead article with Prof Patricia Danzon from the Wharton School and Dr Andrew Mulcahy of RAND.

In October 2009, the OHE published research that compared access to orphan medicinal products (OMPs) in selected European countries. At the request of the UK Orphan Medicines Industry Group [1], OHE recently updated to May 2011 some of the data included in that research.

Most patients in middle and low income countries (MLICs) lack insurance coverage and so pay out of pocket for prescription medicines; pricing commensurate with income thus becomes critical to access to drugs. In this paper, the authors examine what determines the prices that manufacturers charge for originator and generic drugs across countries at all income levels.

To date, the UK Government has not been specific about how VBP will be implemented, but has indicated that calculations of value will extend beyond the QALY approach currently used by NICE. The Department of Health has stated that it will include “the range of factors through which medicines deliver benefits for patients and society”.

OHE is making available as Occasional Papers drafts of two important chapters that will appear in the Oxford Handbook on the Economics of the Pharmaceutical Industry due out in 2012. One on access to drugs and vaccines in developing countries and the other on measuring value with pharmacoeconomics.

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