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How can pricing and reimbursement policies improve affordable access to medicines? Lessons learned from European countries

Vogler, Sabine, Paris, Valérie, Ferrario, Alessandra, Wirtz, Veronika J., Joncheere, Kees de, Schneider, Peter, Pedersen, Hanne Bak, Dedet, Guillaume and Babar, Zaheer-Ud-Din (2017) How can pricing and reimbursement policies improve affordable access to medicines? Lessons learned from European countries. Applied Health Economics and Health Policy, 15 (3). pp. 307-321. ISSN 1175-5652

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Identification Number: 10.1007/s40258-016-0300-z

Abstract

This article discusses pharmaceutical pricing and reimbursement policies in European countries with regard to their ability to ensure affordable access to medicines. A frequently applied pricing policy is external price referencing. While it provides some benchmark for policy-makers and has been shown to be able to generate savings, it may also contribute to delay in product launch in countries where medicine prices are low. Value-based pricing has been proposed as a policy that promotes access while rewarding useful innovation; however, implementing it has proven quite challenging. For high-priced medicines, managed-entry agreements are increasingly used. These agreements allow policy-makers to manage uncertainty and obtain lower prices. They can also facilitate earlier market access in case of limited evidence about added therapeutic value of the medicine. However, these agreements raise transparency concerns due to the confidentiality clause. Tendering as used in the hospital and offpatent outpatient sectors has been proven to reduce medicine prices but it requires a robust framework and appropriate design with clear strategic goals in order to prevent shortages. These pricing and reimbursement policies are supplemented by the widespread use of Health Technology Assessment to inform decision-making, and by strategies to improve the uptake of generics, and also biosimilars. While European countries have been implementing a set of policy options, there is a lack of thorough impact assessments of several pricing and reimbursement policies on affordable access. Increased cooperation between authorities, experience sharing and improving transparency on price information, including the disclosure of confidential discounts, are opportunities to address current challenges.

Item Type: Article
Official URL: http://link.springer.com/journal/40258
Additional Information: © 2017 Springer International Publishing Switzerland
Divisions: Social Policy
LSE Health
Subjects: R Medicine > RA Public aspects of medicine
JEL classification: I - Health, Education, and Welfare > I1 - Health > I10 - General
Sets: Departments > Social Policy
Research centres and groups > LSE Health
Date Deposited: 13 Jan 2017 17:01
Last Modified: 20 Jun 2020 02:23
URI: http://eprints.lse.ac.uk/id/eprint/68862

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