Unravelling Drug Reimbursement Outcomes: A Comparative Study of the Role of Pharmacoeconomic Evidence in Dutch and Swedish Reimbursement Decision Making

Franken, M; Nilsson, Fredrik; Sandmann, Frank; Boer, Anthonius de; Koopmanschap, Marc

doi:10.1007/s40273-013-0074-1

Cited by 27 publications

(32 citation statements)

References 20 publications

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“…Decisions are either based on a simple cost-minimization analysis (CMA) or a cost-utility analysis (CUA) [17]. CMA (price comparison) is used when a drug is judged to be clinically equivalent to the comparator (n = 252), whereas a CUA is needed if a pharmaceutical company claims an added therapeutic value and a price premium over its comparators (n = 102).…”

Section: Datamentioning

confidence: 99%

Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness

2015

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Section: Datamentioning

confidence: 99%

Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness

2015

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“…Based on this hierarchical model, technologies that (would subsequently) pass all criteria were to be included in the basic benefits package. The report was pivotal for the discussion on priority setting, and in the following years, the criteria were put into practice [2,6,27]. The Dutch Health Care Institute (ZiN) later reformulated these criteria as necessity of care, effectiveness, cost-effectiveness, and necessity of insurance, respectively, and supplemented these with a feasibility criterion [1,28].…”

Section: A Brief History Of Healthcare Priority Setting In the Nethermentioning

confidence: 99%

“…However, the outcomes of economic evaluations only predict such decisions to a moderate extent [3,5,6]. One explanation for this disparity is that decision makers are not exclusively concerned with maximising health given available budgets, but also with distributing health(care) equitably and fairly [3,5,7,8].…”

Section: Introductionmentioning

confidence: 99%

Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands

2018

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a b s t r a c tThe increasing demand for healthcare and the resulting pressure on available budgets render priority setting inevitable. If societies aim to improve health and distribute health(care) fairly, equity-efficiency trade-offs are necessary. In the Netherlands, proportional shortfall (PS) was introduced to quantify necessity of care, allowing a direct equity-efficiency trade-off. This study describes the history and application of PS in the Netherlands and examines the theoretical and empirical support for PS as well as its current role in healthcare decision making. We reviewed the international literature on PS from 2001 onwards, along with publicly accessible meeting reports from the Dutch appraisal committee, Adviescommissie Pakket (ACP), from 2013 to 2016. Our results indicate that there is support for the decision model in which necessity is quantified and incremental cost-effectiveness ratios are evaluated against associated monetary reference values. The model enables a uniform framework for priority setting across all healthcare sectors. Although consensus about the application of PS has not yet been reached and alternative ways to quantify necessity were found in ACP reports, PS has increasingly been applied in decision making since 2015. However, empirical support for PS is limited and it may insufficiently reflect societal preferences regarding age and reducing lifetime-health inequalities. Hence, further investigation into refining PS-or exploration of another approach-appears warranted for operationalising the equity-efficiency trade-off.

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“…(5,6) The literature has generally examined this issue from the perspective of the last available listing recommendation, and has suggested that international differences are accounted by social determinants, including preferences for treatment, disease severity and rarity (7,8) and local clinical practice;(4) as well as methodological factors, including HTA design and sufficiency of pharmacoeconomic evidence, (7,9) and use of comparative data. (4) As has been previously argued, however, HTA is a complex process that cannot be fully understood if the perspective concentrates exclusively on final listing decisions.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of drug listing recommendations and the decision-making process in Australia, the Netherlands, Sweden, and the UK

2016

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Drug listing recommendations from health technology assessment (HTA) agencies often fail to coincide with one another. We conducted a comparative analysis of listing recommendations in Australia (PBAC), the Netherlands (CVZ), Sweden (TLV) and the UK (NICE) over time, examined interagency agreement, and explored how process-related factors-including time delay between HTA evaluations, therapeutic indication and orphan drug status, measure of health economic value, and comparator-impacted decision-making in drug coverage. Agreement was poor to moderate across HTA agency listing recommendations, yet it increased as the delay between HTA agency appraisals decreased, when orphan drugs were assessed, and when low-value medicines (immunosuppressants, antineoplastics) were removed from the sample. International differences in drug listing recommendations seem to occur in part due to inconsistencies in how the supporting evidence informs assessment, but also to differences in how domestic priorities shape the value-based decision-making process.

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Unravelling Drug Reimbursement Outcomes: A Comparative Study of the Role of Pharmacoeconomic Evidence in Dutch and Swedish Reimbursement Decision Making

Cited by 27 publications

References 20 publications

Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness

Reimbursement Decisions for Pharmaceuticals in Sweden: The Impact of Disease Severity and Cost Effectiveness

Looking back and moving forward: On the application of proportional shortfall in healthcare priority setting in the Netherlands

A comparative study of drug listing recommendations and the decision-making process in Australia, the Netherlands, Sweden, and the UK

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