Pharmaceutical Cost-Containment Policies and Sustainability: Recent Irish Experience

Kenneally, Martin; Walshe, Valerie

doi:10.1016/j.jval.2011.10.007

Cited by 16 publications

(8 citation statements)

References 9 publications

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“…A priori, user payments for certain health services and prescription drugs, in the form of co-payments (fixed amount), co-insurance rates (share of costs) and/or deductibles (patient reimbursement only above a given minimum threshold cost) can be expected to reduce service utilisation by effectively raising the price of healthcare at the point of use (depth of basic insurance). There is indeed a body of empirical research pointing to lower service use and reduced public health spending in the shorter term due to higher reliance on cost-sharing (Manning et al, 1987;Rubin and Mendelson, 1996;Zweifel and Manning, 2000;Goldman et al, 2007;Schokkaert and van de Voorde, 2011;Kenneally and Walshe, 2012). The longer term effects of higher cost-sharing on health expenditures remain controversial, however, as higher cost-sharing has been found to lead to lower use of needed medical care especially among low-income and high-risk populations, with adverse consequences for health status and potentially higher spending on more expensive care in the future (Manning et al, 1987;Gruber, 2006;Haviland et al, 2011;Rubin and Mendelson, 1996;Lundberg et al, 1998;Robinson, 2002;Jemiai et al, 2004;Kim et al, 2005).…”

Section: Cost-sharingmentioning

confidence: 99%

The Drivers of Public Health Spending: Integrating Policies and Institutions

et al. 2016

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JT03391138 Complete document available on OLIS in its original format This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. ECO/WKP(2016)7 Unclassified English-Or. English ECO/WKP(2016)7 2 OECD Working Papers should not be reported as representing the official views of the OECD or of its member countries. The opinions expressed and arguments employed are those of the author(s). Working Papers describe preliminary results or research in progress by the author(s) and are published to stimulate discussion on a broad range of issues on which the OECD works.

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Section: Cost-sharingmentioning

confidence: 99%

The Drivers of Public Health Spending: Integrating Policies and Institutions

et al. 2016

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“…Adequate budget allocation for limited health resources is needed to alleviate the price burden to improve access to innovative drugs, and various types of cost-containment policies, such as generic/biosimilar drug substitution, actual transaction pricing, pricevolume agreements, and patient access schemes, are used in many countries [6]. The introduction of generics/biosimilars after the loss of patent exclusivity plays a major role in budget savings by significantly decreasing drug prices.…”

Section: Introductionmentioning

confidence: 99%

Use of budget savings from patent expiration of cancer drugs to improve affordability and accessibility

Lee

Kim

Suh

et al. 2021

BMC Health Serv Res

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Background The introduction of generics after the loss of patent exclusivity plays a major role in budget savings by significantly decreasing drug prices. The aims of this study were to estimate the budget savings from off-patent cancer drugs in 2020–2024 and to inform decision makers on how these savings could be used to improve the affordability of innovative cancer treatments in South Korea. Methods A model was developed to calculate budget savings from off-patent cancer drug use in Korea over 5 years (2020–2024). Cancer drugs with one or more valid patents that expire between 2020 and 2024 in Korea were selected. Key input parameters in the model included market share of generics, market growth, and prices of originators and generics. To reflect market dynamics after patent expiration, the trends of the off-patent market were estimated using historical sales volume data of IQVIA from 2012 to 2018. The study assumed that the prices of off-patent drugs decreased according to the price regulations set by the Korean government and that the off-patent market sales volume did not grow. Sensitivity analyses were performed to investigate the uncertainty in model input parameters. Results A total of 24 cancer drugs which met selection criteria were identified. In the base case analysis, patent expiration of cancer drugs between 2020 and 2024 could lead to a spending reduction of ₩234,429 million ($203 million), which was 20% of the cancer drug expenditure in the 5-year period. The savings ranged from ₩157,633 million ($136 million) to ₩434,523 million ($376 million) depending on the scenarios in sensitivity analyses. Conclusions The findings indicate that patent loss of cancer drugs could lead to a 20% reduction in spending on cancer drugs over the next 5 years in South Korea. The savings could be used to improve the affordability of innovative, advanced cancer drugs for 94,000 cancer patients by reallocating the budget savings from patent expiration.

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“…12 Amid concerns over health system sustainability and pressure from the European Union/International Monetary Fund Programme of Financial Support, Ireland introduced an array of cost-containment measures over the last decade. 13 With the goal of achieving better value for money on pharmaceuticals, such measures include the introduction of a co-payment policy and a model for reference pricing.…”

Section: Introductionmentioning

confidence: 99%

Trends in national pharmaceutical expenditure on diabetes in Ireland 2011–2015: a repeated cross-sectional study

et al. 2020

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ObjectivesTo explore trends in pharmaceutical expenditure on diabetes between 2011 and 2015, describing trends in expenditure on blood glucose-lowering medications and estimating the effect of cost-containment measures implemented during this time.DesignRepeated cross-sectional study of national pharmacy claims data in Ireland.ParticipantsPatients’ dispensed items used in the treatment or management of diabetes.Primary and secondary outcomesTotal expenditure associated with diabetes was calculated by extracting data on all diabetes-related items dispensed to eligible patients. Costs were categorised into two groups. Diabetes-specific items include items used directly in diabetes treatment (WHO-Anatomical Therapeutic Chemical (ATC): A10, V07, V04) and diabetes-related include all other condition-related items (WHO-ATC: B01, C, H04, N03, N06). The impacts of two specific cost-containment measures, co-payments and reference pricing, were assessed using segmented linear regression analyses of interrupted time-series.ResultsTotal expenditure varied over the study period, peaking at €216 994 441 in 2012. Expenditure on diabetes-specific items increased steadily by 18% reaching €153 621 477 in 2015, with blood glucose-lowering medications accounting for 73% of this increase. During the same period, expenditure on diabetes-related items decreased by 32% to €50 835 856. The introduction of reference pricing for atorvastatin in November 2013 resulted in immediate costs savings of €2.4 million per yearly quarter (level-change p<0.001).ConclusionsThe increasing expenditure on blood glucose-lowering medications negates the effect of recent cost-containment measures, presenting a significant challenge for the provision of diabetes care. Innovative policies are required to ensure high-quality diabetes care can be provided at an equitable, affordable and sustainable rate.

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Pharmaceutical Cost-Containment Policies and Sustainability: Recent Irish Experience

Abstract: Our findings highlight the need for policymakers, even when absorbed with reducing cost, to design cost-containment policies that are both fiscally and economically sustainable.

Cited by 16 publications

References 9 publications

The Drivers of Public Health Spending: Integrating Policies and Institutions

The Drivers of Public Health Spending: Integrating Policies and Institutions

Use of budget savings from patent expiration of cancer drugs to improve affordability and accessibility

Trends in national pharmaceutical expenditure on diabetes in Ireland 2011–2015: a repeated cross-sectional study

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