Approaches to Pharmaceutical Regulation in Europe and the USA
Agenda
Health and Pharmaceutical Policy, 1974 - 2002
PPT Slide
Resource allocation and pharmaceuticals: the Supply-side
Rate of Return Regulation
Bi-lateral comparisons of ex-manufacturer prices (UK=100)
Multi-lateral comparisons of ex-manufacturer prices (UK=100)
Research and Development Tax Incentives in Selected Countries: Summary of Policies
Price Setting Regulation
Pricing & Reimbursement Methodologies: Managing the Supply Side
Pricing & Reimbursement Methodologies: Controlling the Supply Side
Reference Pricing variations
Types of “Agreements”
Health Economics: Official Requirements
There is Significant Variation in the Time it Takes Products to Access Price-Regulated Markets
Cox-2 inhibitors have generally achieved price premia relative to branded NSAIDs
Entry prices at starting dosages for new type II diabetes treatments
Price Cuts in France Become Become More Regular and Can be Significant
Lots of different prices …
… continued
How representative are these prices?
Medicare – Part B and AWP
Discounts from AWP, 2001
Medicare – The Future
The role of FSS price
Pharmaceutical Policy in 7 States (Connecticut, Delaware, Florida, Maine, Massachusetts, New Hampshire, New York)
States’ source of disillusionment
Key issue: maintain quality of care whilst containing increasing costs (but also manage budgets more effectively & reduce waste)
Policy framework: OBRA 1990 & 1993
… States’ gradual transformation
Measures at state level - I
Measures at state level - II
Reference pricing - which version?
“Reference” Pricing in the US
Physician incentives - feasibility? - budgetary incentives? - carrots or sticks?
Physician incentives - feasibility
Voluntary Incentive Scheme
Admission into the “positive” list - criteria - definition of innovation
Formulary Management
Aggressive bargaining - P/Q? - Periodic reviews?
Rebates & discounts over and above Medicaid requirements
Overall concluding remarks
Panos Kanavos, Lecturer in International Health Policy, LSE Health and Social Care, UK
pmprb@pmprb-cepmb.gc.ca
http://www.pmprb.com/symposium2002/present-e.html
