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Pharmaceutical Pricing and Reimbursement News in the Second Quarter of 2008
Decision Resources, Inc., July 2008, Pages: 40

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Executive Summary 5
Strategic Considerations 5
Stakeholder Implications 5
Overview 6

United States 7
Pharmacy Benefit Management Trends 7
Recent Spending Trends 7
Pricing 8
Increasing Use of Generics 8
Specialty Pharmacy 11
Outlook 12
Medicare Reforms 13
Approval of New Active Surveillance System 15

European Union 16
Expansion of European Commission’s Antitrust Investigation 16
France 17
Impact of New Patient Charge 17
Call for a Review of the Prescription, Consumption, and Taxation of Medicines 17
Rollout of Personal Medical Dossiers Extended 18
Government Plan for a Major New Cost-Containment Strategy 18
Germany 19
Rapid Growth of Rebate Contracts 19
Impact of Reference Price Cuts 21
Clarifi cation of Second Opinion Process 22
Italy 23
Prescribing Trends in 2007 23
Spain 23
New Government Health Plan 23
Strongest Sales Growth for High-Priced Drugs 28
Steady Growth in the Prescription Drug Market 29
United Kingdom 29
Tentative Agreement on Price Cuts in Negotiations for New Drug Pricing System 29
Promise of Improved Market Access for Innovative Medicines 30
Growing Industry Disillusionment with the U K Market 32
Initiative to Increase the Use of Statins 32
Eisai’s Legal Victory over NICE 33

Japan 34
Industry Proposal for a New Drug Pricing System 34
Unprecedented Focus on Expanding the Generics Market 34
Outlook and Implications for the Pharmaceutical Industry 36

List of Figures:

1 Leading PBMs’ Growth Rates for Per Member Per Month Spending on Specialty Pharmaceuticals and Prescription Drugs Overall, 2007 7
2 Leading PBMs’ Reported Changes in Drug Prices, 2007 8
3 Express Scripts’ Reported Changes in Average Prices of Select Drug Classes, 2007 9
4 Leading PBMs’ Generics Dispensing Rates, 2006-2007 10
5 Express Scripts’ Calculations of Actual and Potential Generics Dispensing Rates and Potential Savings, 2007 11
6 Express Scripts’ Projected Growth Rates for Per Member Per Month Spending on Specialty and Nonspecialty Drugs, 2008-2011 13
7 Distribution of Rebate Contracts in Germany, April 2008 20
8 Pharmaceutical Consumption in Italy, 2003-2007 24
9 Pharmaceutical Spending in Italy, 2003-2007 25
10 Contribution of Changes in Prescribing Volume, Drug Price, and Product Mix to Overall Spending Trends for Fully Reimbursed Drugs in Italy, 2003-2007 26
11 Generics’ and Off-Patent Branded Drugs’ Share of Spending on Fully Reimbursed Drugs in Italy, 2003-2007 27
12 Spanish Pharmaceutical Market Trends by Product Price Range, 2001-2006 28
13 Generics’ Share of the Japanese Pharmaceutical Market, 2002-2006 35


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