Drug Reimbursement Regulation in 6 Peer Countries

Abstract

for errors of language and a percentage in the Australia section.

Variation in the prices of oncology medicines across Europe and the implications for the future

“…However, they found greater differences for lower priced medicines (40). Similarly, Vokinger et al (2020) observed limited differences in the monthly treatment costs for new oncology medicines among European countries; however, costs of medicines in the USA were a median of 2.31 times higher than those seen in Europe reflecting the current lack of pricing controls in the USA (39,41). The situation in Europe may reflect extensive external referencing pricing for new medicines (25,42), although we have seen considerable differences in the pricing of multiple sourced oncology medicines among European countries (43).…”

“…This contrasts with the USA with currently no formal pricing and reimbursement systems, with concerns that the system is not working leading to spending on medicines currently accounting for over 40% of global pharmaceutical spend despite the USA only having 4.5% of the world's population (39). In addition, increasing calls from US groups for the government to consider approaches and systems from among European and other countries going forward given the unsustainability of their current system (39). We have adopted a payer perspective for our research as they are key personnel involved in funding and reimbursement decisions for new oncology medicines across Europe.…”

“…Once prices for medicines are established in Europe, there appears to be limited price erosion until multiple sources become available unlike the situation in the USA (38,39). There also appears to be limited differences among European countries regarding prices for patented biological oncology medicines, with Vogler et al (2017) only demonstrating a 13% difference among 16 European countries for prices including bevacizumab and ipilimumab.…”

“…We have chosen to concentrate on Europe for this combined research in view of their goals of equitable and universal healthcare, growing concerns with expenditure on new oncology medicines and those for orphan diseases, and multiple ongoing activities to improve the efficiency and quality of prescribing for both new and established medicines (20,21,25,(47)(48)(49)(50)(51). European countries also have formal pricing and reimbursement processes with input from health technology agencies and others, with processes the jurisdiction of each Member State, to review and refine future approaches (25,39,52). This contrasts with the USA with currently no formal pricing and reimbursement systems, with concerns that the system is not working leading to spending on medicines currently accounting for over 40% of global pharmaceutical spend despite the USA only having 4.5% of the world's population (39).…”

“…European countries also have formal pricing and reimbursement processes with input from health technology agencies and others, with processes the jurisdiction of each Member State, to review and refine future approaches (25,39,52). This contrasts with the USA with currently no formal pricing and reimbursement systems, with concerns that the system is not working leading to spending on medicines currently accounting for over 40% of global pharmaceutical spend despite the USA only having 4.5% of the world's population (39). In addition, increasing calls from US groups for the government to consider approaches and systems from among European and other countries going forward given the unsustainability of their current system (39).…”