Estimating the Potential Annual Welfare Impact of Innovative Drugs in Use in Switzerland

Pavic, Matea; Pfeil, Alena M.; Szucs, Thomas D.

doi:10.3389/fpubh.2014.00048

Cited by 8 publications

(6 citation statements)

References 41 publications

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“…The main finding of this study is that drug recentness was associated with an increase in drug expenditure, confirming former studies stating that pharmaceuticals recently introduced to the Swiss market generated higher costs [36]. In most economic sectors, new products enables the competitors to keep market shares, in a context of stable or decreasing prices.…”

Section: Discussionsupporting

confidence: 85%

Determinants of drug expenditure in the Swiss healthcare market in 2006

Eggli

Decollogny

Piaget-Rossel

et al. 2022

BMC Health Serv Res

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Background Several measures are in force in Switzerland to control the cost of drugs, but are not effective enough. There are many determinants influencing these expenditures, related to treatments, markets, physicians, patients and regions, but their impact on costs is not clear. Methods We applied a Bayesian multilevel model with five levels to adjust for patients, drugs’ market, and physicians ‘characteristics, treatment type, and district (i.e. Swiss canton). We used data of the Swiss drugs’ market in 2006, offering real choices for doctors and patients (multiple products for similar active substances), with a neutral position of pharmacists (no financial incentives). Results Variance partitioning of yearly drugs’ cost per insured showed that market level (delivered substance) contributed to 76% of the variance, treatment level (delivered product) to 20%, whereas patients’ and physicians’ levels accounted for only 2% each, without significant differences between Swiss cantons. After adjusting for covariables at each level, the model explained about 51% of the variation at the market and 20% at the treatment levels. We found that older but substitutable drugs, generics, larger size of the market and physician’s specialty were associated with lower expenditure, whereas drugs requiring a physician’s prescription, the number of prescribers per patient, patient’ age, male gender, and comorbidities increased expenditure. Our results show that for a specific medication the yearly cost of recently released drugs was 36 CHF higher than for similar and substitutable drugs introduced 15 years earlier, corresponding to one third of the average annual treatment cost observed in our dataset. Competition did not seem to be effective to reduce expenditure on the drug market. Conclusion The main finding of this study is that recentness of drugs was associated with an increase in drug expenditure in 2006, even after adjustment for all non-controllable determinants. Further research is recommended to confirm those results with updated data.

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Section: Discussionsupporting

confidence: 85%

Determinants of drug expenditure in the Swiss healthcare market in 2006

Eggli

Decollogny

Piaget-Rossel

et al. 2022

BMC Health Serv Res

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“…In terms of cost-effectiveness thresholds adopted in Switzerland, for some interventions a threshold of CHF 100,000 per QALY, from the perspective of the statutory health insurance, has been tentatively assumed in previous analyses [47][48][49]. However, for ultra-orphan diseases, it may be appropriate to consider a higher threshold; for instance NICE in the United Kingdom recognises thresholds ranging from GBP 100,000 to 300,000 (CHF 122,000 to 366,000) depending on the size of treatment effect, for ultra-orphan diseases [50].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of voretigene neparvovec in the treatment of patients with inherited retinal disease with RPE65 mutation in Switzerland

Bhadhuri

Dröschel

Guldimann

et al. 2022

BMC Health Serv Res

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Objective We aimed to evaluate the cost-effectiveness of voretigene neparvovec (VN) compared with standard of care (SoC) for patients with inherited retinal disease (IRD) caused by a biallelic RPE65-mutation. VN is a live, non-replicating adeno-associated virus serotype 2 (AAV2). SoC is best supportive care provided to patients with visual impairment. Patients under SoC may experience progressive vision loss leading to complete blindness. Methods We adapted a previously published Markov cohort model for IRD. An annual cycle length, life-long time horizon, discount rate of 3% for cost and health outcomes, and Swiss health system perspective were used. Data from a randomised controlled phase III trial of VN versus SoC (ClinicalTrials.gov: NCT00999609) were used to estimate transitions between health states in the first year, after which VN patients were assumed to remain for 39 subsequent years in the health state they were in at the end of the first year. After the 40th year for VN patients and 1st year for SoC patients, visual decline was modelled based on observational data on the natural progression of the disease. Quality-adjusted life years (QALYs) were calculated based on an external study which elicited clinicians’ EQ-5D-5L-based utility estimates for IRD patients with a RPE65-mutation. Costs (Swiss Francs (CHF), year 2018-2019) included drug acquisition/ administration, adverse events, testing for sufficient viable retinal cells, and healthcare-related costs of blindness. Societal costs of blindness were added in a complementary analysis. Robustness of the model results were tested in sensitivity and scenario analyses. Results For the base-case, VN resulted in incremental costs per patient of CHF 764’402 (VN: CHF 901’654, SoC: CHF 137’252), incremental blindness-free years of 7.67 (VN: 28.32, SoC: 20.65) and incremental QALYs of 6.73 (VN: 18.35, SoC: 11.62), leading to an incremental cost-effectiveness ratio of CHF 113’526 per QALY gained. In probabilistic sensitivity analysis, the cost-effectiveness of VN was better than CHF 100,000 per QALY gained in 41% of iterations. For the scenario analysis in which a societal perspective was adopted and for which a 50% work-related productivity loss from blindness was assumed, incremental costs of CHF 423,837 and an ICER of CHF 62’947 per QALY gained were produced. The scenario assuming VN treatment effect lasts for 20 years produced an ICER of CHF 156’171 per QALY gained, whereas assuming a life-long VN treatment effect resulted in an ICER of CHF 96’384 per QALY gained. Conclusion The incremental cost-effectiveness ratio of VN compared to the SoC was estimated to be CHF 113’526 and CHF 62’947 per QALY gained, respectively, from a Swiss healthcare system, and societal perspective assuming a 50% productivity loss.

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“…The increasing consumption of infant formula is reflective of an overall increase in healthcare and pharmaceutical expenditure in the country, which have increased by more than 50% over the last 8 years (Ortiz-Prado, Galarza-Maldonado, Cornejo, & Ponce, 2014). The amount of resources allocated to drug and pharmaceutical consumption is proportionally greater in Ecuador than in some high income countries (Ortiz-Prado et al, 2014;Pavic, Pfeil, & Szucs, 2014).…”

Section: Discussionmentioning

confidence: 99%

Artificial Infant Formula Consumption and Breastfeeding Trends in Ecuador, A Population-Based Analysis from 2007 to 2014

Ortíz-Prado¹,

Stewart-Ibarra²,

Ramirez³

et al. 2016

GJHS

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Objective: The aim of this study was to analyze trends in infant breastfeeding and artificial infant milk consumption in Ecuador from 2007 to 2014. Methods:This descriptive observational study includes all the available data collected and adapted from the National Health and Nutrition Survey of Ecuador, ENSANUT, the Ecuadorian National Institute of Census and Statistics, the national report of the International Marketing Services and data from Enfarma EP. Descriptive and inferential statistics were used to determine sociodemographic distribution and temporal trends. Results:In Ecuador 54% of children initiate breastfeeding during the first hour of life, and 43% of children aged five months are breastfed exclusively. 76% of children under one month of age and 60% of children under six months consume artificial infant formula. Over the last 8 years infant formula consumption has tripled in Ecuador reaching 59.6 million units sold at a cost of $530,100,000 USD from 2007 to 2014. Conclusions:Breastfeeding practices in Ecuador are not complying with WHO recommendations and infant milk formulas consumption has risen significantly since 2007, despite active campaigns by the public health sector to educate women as to the benefits of breastfeeding.

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Estimating the Potential Annual Welfare Impact of Innovative Drugs in Use in Switzerland

Cited by 8 publications

References 41 publications

Determinants of drug expenditure in the Swiss healthcare market in 2006

Determinants of drug expenditure in the Swiss healthcare market in 2006

Cost-effectiveness of voretigene neparvovec in the treatment of patients with inherited retinal disease with RPE65 mutation in Switzerland

Artificial Infant Formula Consumption and Breastfeeding Trends in Ecuador, A Population-Based Analysis from 2007 to 2014

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