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Drug Price/Cost Debate: Coping with Escalating Pricing Pressures
Decision Resources, Inc., Nov 2009, Pages: 35
Insinuations of profiteering were made against an H1N1 swine flu vaccine manufacturer in the summer of 2009.
As the swine flu epidemic began to take on serious proportions, public scrutiny in the United Kingdom focused on manufacturers developing vaccines for the prevention of this disease and on what constitutes a fair price for a drug. The U.K. public’s suspicion of pharmaceutical profiteering in the H1N1 vaccine arena is just the tip of the iceberg in the ongoing and acrimonious battle over the prices that pharmaceutical companies charge for drugs and the costs that payers must cover to meet the increasing demands for healthcare. With global economies in the tank owing to the ongoing worldwide recession, the pitch of the battle increased in 2009. Some companies are developing new strategies to combat increased price/cost pressures. Who has been successful, and who has not? What strategies are in play, and which ones are working? What duck-and-cover strategies are skittish manufacturers attempting? In this report, we discuss elements of the escalating drug price/cost battle, the cost-containment measures that governments are implementing, and the new strategies that companies are devising to cope with increasing pricing pressures.
Governments around the world . . .
. . . avidly follow the National Center for Health and Clinical Excellence’s (NICE’s) battle to rigorously pursue cost-effectiveness assessments in the United Kingdom and keep some drugs off the National Health Service. At the same time, the Obama administration is engaged in an increasingly acrimonious debate in the United States about how to broaden access to healthcare without bankrupting the country in the process. It is highly likely that this administration will closely scrutinize NICE for insights on what works and what does not to control escalating healthcare costs. So, the overriding question for the world’s largest drug market is: Will Obama be NICE to the U.S. pharmaceutical industry?
Questions Answered in This Report
The inescapable fact is that governments have to make decisions about how limited healthcare budgets will be spent.
- What cost-containment measures have European countries adopted?
- What new pricing strategies are companies inventing to make their drugs acceptable to reimbursement authorities such as NICE and IQWiG?
- Which pharma companies will be the winners in the drug price/cost debate?
After a tortuous process that involved both judicial review and a court appeal, NICE published amended guidance on four medicines for the treatment of Alzheimer’s disease.
- Why are NICE’s decisions so controversial?
- What recommendations did NICE make in its technology appraisals for new drugs in 2009?
- What recent decisions did IQWiG make that will impact drug manufacturers in Germany? What lessons can drug manufacturers learn?
Companies are developing new approaches to cope with increasing pricing pressures and changing market dynamics.
- What ten tactics are companies using?
- Why are companies entering generics markets?
How are companies spreading risk?
Scope
Drug pricing: Swine flu vaccine, profiteering, comparison of drug prices in different countries, free pricing markets, generic pricing.
Cost-containment measures: Cost-effectiveness, value-for-money, reference prices, arbitrary price cuts, generics, biosimilars, claw-back systems, technology appraisals, price caps, China, European countries, Japan, Sweden, the Philippines, revocation of operating licenses, suspension of marketing permits, value-based pricing, biennial price cuts, price cuts on generics, Taiwan, United Kingdom, Pharmaceutical Price Regulation Scheme, controlling drug company profits, controlling pharmacy profits, generic prescribing, generic substitution, generic promotion, European Generic Association, generic penetration rates across Europe, Pharmaceutical Pricing and Reimbursement Information Project, ten measures to promote the use of generic medicines.
NICE: National Institute for Health and Clinical Excellence, guidance documents published in 2009, Alzheimer’s disease, renal cell carcinoma, Eisai/Pfizer’s Aricept, Shire’s Reminyl, Novartis’s Exelon, Lundbeck’s Ebixa, judicial decision, Court of Appeal, Roche’s Avastin, Bayer’s Nexavar, Wyeth’s Torisel, Pfizer’s Sutent, life-extending, end-of-life treatments, incremental cost-effectiveness ratio (ICER), quality-adjusted life year (QALY), locally proven efficacy, Roche’s Pegasys, Gilead Sciences’ Adefovir, Sanofi -Aventis’s Plavix, Pfizer’s Macugen, Abbott’s Humira, Wyeth’s Enbrel, Schering-Plough’s Remicade, Servier’s Protelos.
IQWiG: Institute for Quality and Efficiency in Health Care, Gemeinsame Bundesausschuss (GBA), Federal Joint Committee, evidence-based decisions, Novo Nordisk’s Novorapid, Eli Lilly’s Humalog/ Liprolog, Sanofi -Aventis’s Apidra, insulin analogues, value added, Pfizer’s Exubera, Sanofi -Aventis’s Lantus, Novo Nordisk’s Levemir, cancer risk, Pfizer’s Edronax, GlaxoSmithKline’s bupropion, Essex Pharma’s mirtazapine.
Price-coping strategies: Ten tactics that companies are using to cope with increasing pricing pressures, Center for Responsible Politics, Pfizer’s Sutent, Celgene’s Revlimid, Novartis’s Lucentis, Pfizer’s Macugen, GlaxoSmithKline’s Tyverb, Bayer’s Nexavar.
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