Evaluating the costs and benefits of using combination therapies

Clarke, Philip; Avery, Alex

doi:10.5694/mja14.00199

Cited by 20 publications

(21 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most FDCs are still under patent, while the individual components are not. As a result, FDCs can incur higher costs for third party payers in many jurisdictions, compared with subsidising the individual components . Moreover, until recently, the amlodipine/atorvastatin FDC was more expensive than accessing the individual components for Australians subject to the highest PBS copayments .…”

Section: Discussionmentioning

confidence: 99%

Who benefits from fixed‐dose combinations? Two‐year statin adherence trajectories in initiators of combined amlodipine/atorvastatin therapy

Schaffer

Buckley

Pearson

2017

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Who benefits from fixed‐dose combinations? Two‐year statin adherence trajectories in initiators of combined amlodipine/atorvastatin therapy

Schaffer

Buckley

Pearson

2017

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

“…First, no polypill has had regulatory approval in Australia to date. While several cardiovascular combinations have been approved, these are simple two‐component combinations approved on the basis of straight substitution among patients receiving recommended medications (among whom the benefits are smallest), 3 , 4 and have probably increased costs as a result of not being subject to automatic price reductions 16 . Another challenge will be appropriate scale‐up while maintaining overall cost savings — large investments will be required in order to bring about practice change for this relatively new way of treating patients.…”

Section: Discussionmentioning

confidence: 99%

“…While several cardiovascular combinations have been approved, these are simple two-component combinations and have probably increased costs as a result of not being subject to automatic price reductions. 16 Another challenge will be appropriate scaleup while maintaining overall cost savings -large investments will be required in order to bring about practice change for this relatively new way of treating patients. One limitation with using PBS data is that over-the-counter and very lowcost medications priced at below the government copayment level are not captured.…”

Section: Discussionmentioning

confidence: 99%

An economic case for a cardiovascular polypill? A cost analysis of the Kanyini GAP trial

Laba

Hayes

et al. 2014

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…The case studies presented herein demonstrate the effects of the loss of cost-minimisation between combination products and their individual components, which is made possible by the marketing of multiple brands of the same combination product. 1 The combination and individual component products are on the price disclosure list, but separate price reductions are estimated for each product. The price of the three combination products reported herein decreased at lower rates than at least one of their individual components, leading to potential cost savings of almost A$25 million in the incomplete financial year to April 2015.…”

Section: Discussionmentioning

confidence: 99%

Costs of paying higher prices for equivalent effects on the Pharmaceutical Benefits Scheme

Karnon¹,

Edney²,

Sorich³

2017

Aust. Health Review

View full text Add to dashboard Cite

Objective. The aims of the present study were to illustrate and discuss the effects of the non-maintenance of equivalent prices when the comparators of pharmaceuticals listed on the Pharmaceutical Benefits Schedule (PBS) on a costminimisation basis come off-patent and are subject to statutory price reductions, as well as further potential price reductions because of the effects of price disclosure.Methods. Service use, benefits paid, and price data were analysed for a selected sample of pharmaceuticals recommended for listing on a cost-minimisation basis between 2008 and 2011, and their comparators, to estimate the cost savings to the PBS of maintaining equivalent prices.Results. Potential cost savings for 12 pharmaceuticals, including alternative compounds and combination products across nine therapeutic groups, ranged from A$570 000 to A$40 million to April 2015. Potential savings increased significantly following recent amendments to the price disclosure process.Conclusions. Potential savings from maintaining equivalent prices for all pharmaceuticals listed on the PBS on a costminimisation basis could be over A$500 million per year. Actions to reduce these costs can be taken within existing policy frameworks, but legislative and political barriers may need to be addressed to minimise these costs, which are incurred by the taxpayer for no additional benefit.What is known about the topic? Pharmaceuticals listed on the PBS must provide value for money. Many pharmaceuticals achieve this by demonstrating equal effectiveness to an already listed pharmaceutical and requesting the same price as this comparator; that is, listing on a cost-minimisation basis. When the comparator moves off-patent, the price of the stillpatented pharmaceutical is protected, whereas the off-patent drug is subject to price disclosure and often steep price reductions. What does this paper add? This paper adds to recent evidence on the costs to government of paying different prices for two or more pharmaceuticals that are equally effective. Between 2008 and 2011, the direct comparators for 68 pharmaceuticals listed on a cost-minimisation basis have moved onto the price disclosure list. Across 12 of these listings, the potential cost savings in the 10 months to April 2015 were A$73 million. What are the implications for practitioners? The PBS costs the Australian government over A$9 billion per year. Annual savings over A$500 million per year could be achieved by maintaining cost-minimisation across equally effective pharmaceuticals. This would improve the efficiency of the PBS at no risk to patients. Legislation is required to remove the existing F1 and F2 categorisation of listed pharmaceuticals, but the proposed changes would remove the need for therapeutic group premiums and simplify the pricing of PBS items.

show abstract

Evaluating the costs and benefits of using combination therapies

Cited by 20 publications

References 6 publications

Who benefits from fixed‐dose combinations? Two‐year statin adherence trajectories in initiators of combined amlodipine/atorvastatin therapy

Who benefits from fixed‐dose combinations? Two‐year statin adherence trajectories in initiators of combined amlodipine/atorvastatin therapy

An economic case for a cardiovascular polypill? A cost analysis of the Kanyini GAP trial

Costs of paying higher prices for equivalent effects on the Pharmaceutical Benefits Scheme

Contact Info

Product

Resources

About