price-cut was due to the actual transaction pricing, but its impact on the reduction rate was the smallest (-4.00%). The highest reduction rate per event was the priceadjustment at the timing of generic approvals (-16.29%) and the policy change for off-patent drugs' pricing in April 2012 (-18.15%). In terms of total reduction, the most relatively important characteristic was whether being the originator or the generic drug (50.9%) and annual sales followed it (12.9%). The Listing year contributed to the annual reduction rate most (64.1%) and whether being the originator or the generic drug was also slightly important (14.1%). Conclusions: The repricing mechanism affects the price of anti-cancer drugs in a variety of ways. It is conclusive that statutory adjustments due to Actual transaction price and patent-off are the most active and influential on price change. The most critical factors driving price change are whether to be an originator or not and when to have been listed. To be more efficient and reconciled pricing system, it needs to reinforce an autonomous or competitive mechanism and value assessment.
Objectives: This study aims to evaluate the readiness for collaboration between private health insurance (PHI) and pharmaceutical companies in Egypt. Methods: On-site survey on the 2 nd of April 2019 was administered during a workshop attended by decision makers representing different private health insurance players (Third party administrator-TPA, insurer, Health Maintenance Organization-HMO). Anonymous voting was conducted on questions evaluating key elements for collaboration: trust; common objectives; perceived benefits; ideas for collaboration. An online survey was used to evaluate the same concept among decision makers from several pharmaceutical companies in Egypt. Twenty-four representatives from the PHI responded to the survey, and ten representatives filled in the online survey. Results: The PHI had weak (41%) trust in all their stakeholders (0% meaning no trust, while 100% indicates full trust). Trust in pharmaceutical companies specifically fell below the average (38%). Pharmaceutical companies have higher average trust in their stakeholders (49%), among which their trust in PHI was close to average (48%), higher than their trust in hospitals and physicians (45% each). Fifty eight percent of the respondents from the PHI reported weak to no common purpose with the pharmaceutical companies. On the other hand, 70% of the respondents from the pharmaceutical companies reported they share a common goal. PHI representatives' objective was to acquire the pharmaceutical products at a lower price. Comparably, pharmaceutical companies coincided about having better access to their patients. Ninety percent and 88% of the pharmaceutical companies' and PHI respondents respectively, believe that collaboration would give them a competitive advantage. Conclusions: Although both PHI, and pharmaceutical companies highly believe that collaboration will give each a competitive advantage, there is a trust issue between both parties. For a successful collaboration, both parties must work on building up trust and working on patient benefit as a common interest.
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