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Pricing and Reimbursement Environment for Immune Disease Therapies
Decision Resources, Inc., June 2009, Pages: 45
Drug therapies for immune disorders span an enormous price range—from a few cents per day to tens of thousands of dollars per year. Not surprisingly, payers impose restrictions on the use of the most expensive agents, especially biologics. These restrictions will inevitably intensify in the coming years, as the prevalence of immune disorders increases.
Get the Answers You Need to Shape Your Strategy
- Health technology assessment will increasingly influence coverage of immune disease therapies in most markets in the future. What changes are likely in Europe? How will government support for comparative effectiveness research affect the U.S. market?
- The United States has the highest overall prices of any of the major pharmaceutical markets, but prices for immune and inflammatory drugs vary widely from country to country. How do European and Japanese prices for best-selling immune disease therapies compare with prices in the United States? Which drugs in this therapeutic area are more expensive in Europe and Japan than in the United States?
- Health insurers in the United States generally offer relatively generous coverage of immune disease therapies but are seeking to control their costs. What are the main sources of funding of drug therapy for immune disorders in the United States? What coverage restrictions do payers impose on best-selling immune disease therapies?
- European reimbursement authorities limit access to high-priced immune disease therapies. Which drugs are key targets for reimbursement restrictions in Europe? What role do health technology assessment bodies play in regulating the use of drugs in this therapeutic area?
- The Japanese government has not employed the types of cost-containment measures used in the United States and Europe. How does the Japanese healthcare system control spending on immune disease therapies? What restrictions are imposed on off-label prescribing in Japan?
Scope
- International price comparisons for immune disease therapies: tumor necrosis factor-alpha inhibitors; asthma therapies; immunosuppressants and cytotoxic agents; nonsteroidal anti-inflammatory drugs (NSAIDs); allergy remedies.
- Reimbursement environment in the United States, France, Germany, Italy, Spain, the United
Kingdom, and Japan: general environment; musculoskeletal disorders; respiratory disorders; gastrointestinal disorders; other disorders.
- Outlook and implications for the pharmaceutical industry: impact of health reform in the United States; cost-containment trends; prospects for biosimilars; increasing use of health technology assessment; conditional reimbursement agreements.
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