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Pharma Pricing and Reimbursement Outlook: Optimizing Price and Market Access in a Recessionary Climate Product Image

Pharma Pricing and Reimbursement Outlook: Optimizing Price and Market Access in a Recessionary Climate

  • Published: November 2009
  • Region: Global
  • 145 Pages
  • Scripp Business Insights

Pharmaceutical pricing and reimbursement is highly complex involving a range of market-level policies and interaction with a broad range of regulatory, commercial and healthcare bodies. Local pricing and reimbursement frameworks are constantly evolving in order to balance access to effective medicines against finite budgets. For biopharmaceutical manufacturers, a drug’s pricing and market access strategy is the essential mechanism through which commercial returns on investment will be delivered. They must also coordinate a global pricing strategy to account for the cross-national inter-dependencies that exist in pharmaceutical pricing.

Increased healthcare cost-containment, the fall in pharmaceutical productivity levels and the rising impact of generics have amplified the importance of delivering an optimal pricing and market access strategy. With a back drop of macro-level recession beginning to negatively impact both the supply and demand for pharmaceutical drugs, the challenges facing the pharmaceutical industry have never been greater. Only those companies able to consistently deliver well planned, coordinated and responsive pricing and market access strategies will READ MORE >

Pharma pricing and reimbursement outlook
Executive Summary
Pricing and reimbursement in context
US pricing and reimbursement trends
European pricing and reimbursement trends
Pricing and reimbursement trends in Japan and the rest of the world
Global pricing and market access strategies
Pricing and market access planning

Chapter 1 Pricing and reimbursement in context
Summary
Introduction
Healthcare cost containment
Declining R&D productivity levels
Patent expiries and the impact of generics
The trickle-down effect of global recession
Pharmaceutical pricing and reimbursement outlook

Chapter 2 US pricing and reimbursement trends
Summary
Introduction
US pricing and reimbursement regulations
Private healthcare insurance
Medicare
Medicaid
Key pricing and market access issues
Patent expiries and generics
Follow-on biologics
Cost-effectiveness and budget impact
Innovative pricing agreements
Medicare part D impact and funding
President Obama’s healthcare reform plans
Economic recession
Future trends in US pricing and reimbursement
Most likely scenario
Best case scenario
Worst case scenario

Chapter 3 European pricing and reimbursement trends
Summary
Introduction
European pricing and reimbursement regulations
French pricing and reimbursement regulations
German pricing and reimbursement regulations
Italian pricing and reimbursement regulations
Spanish pricing and reimbursement regulations
UK pricing and reimbursement regulations
Key pricing and market access issues
Decentralization
Generics
Parallel trade
Cost-effectiveness studies
Innovative pricing agreements
Economic recession
Future trends in European pricing and reimbursement
Most likely scenario
Best case scenario
Worst case scenario

Chapter 4 Pricing and reimbursement trends in Japan and the rest of the world
Summary
Introduction
Japanese pricing and reimbursement regulations
Key pricing and market access issues in Japan
Biennial price cuts
Generic pricing and substitution
Innovative drug pricing
Future trends in Japanese pricing and reimbursement
Most likely scenario
Best case scenario
Worst case scenario
High growth emerging pharmaceutical markets
Pricing and reimbursement in Brazil
Pricing and reimbursement in Russia
Pricing and reimbursement in India
Pricing and reimbursement in China

Chapter 5 Global pricing and market access strategies
Summary
Introduction
Local optimization
Price differentials
Market access differentials
Global coordination
Launch sequence
Price differentials
Balancing local optimization and global coordination

Chapter 6 Pricing and market access planning
Summary
Introduction
Pricing research and modeling
Research methodology
Pricing models
Pharmacoeconomic models
Pricing across the lifecycle
Pricing in early stage R&D
Pricing in late stage R&D
Pricing for lifecycle management
Pricing for pharmacoeconomic planning

List of Figures
Figure 1.1: Trends in healthcare spend as a proportion of GDP, 1990-2007
Figure 1.2: Pharmaceutical expenditure as a share of total healthcare expenditure, 1990-2007
Figure 1.3: R&D productivity levels, 1999-2008
Figure 1.4: The rising cost of new drug development, 1975-2006
Figure 1.5: Impact of US patent expiries for leading drugs, 2008-2013
Figure 1.6: Generics market share by sales value, 2003-2007
Figure 1.7: Quarterly GDP growth, Q4 2007 – Q2 2009
Figure 2.8: Projections of total Medicare Part D spending, FY2007-2016
Figure 2.9: Future scenarios for pharmaceutical pricing and reimbursement in the US
Figure 3.10: Pharmaceutical price controls in major European markets
Figure 3.11: Pharmaceutical reimbursement systems in major European markets
Figure 3.12: Italian categorization for innovative new therapies
Figure 3.13: Future scenarios for pharmaceutical pricing and reimbursement in the major European markets
Figure 4.14: The Japanese National Health Insurance system, FY2008
Figure 4.15: Average NHI price cuts, 1998-2008
Figure 4.16: Future scenarios for pharmaceutical pricing and reimbursement in Japan
Figure 4.17: Real GDP growth in BRIC and major markets, 2008
Figure 5.18: International price differentials for leading drugs, 2008
Figure 5.19: Market share for new products launched in last five years, 2007
Figure 5.20: Delays in European market access, 2007
Figure 5.21: External reference pricing in Europe, 2009
Figure 5.22: Parallel imports as a share of pharmacy sales in Europe, 2007
Figure 6.23: Price demand and response curves
Figure 6.24: Market share and revenue impact of reimbursement and formulary status
Figure 6.25: Budget impact modeling

List of Tables
Table 1.1: Trends in healthcare spend as a proportion of GDP, 1990-2007
Table 1.2: Number of NME and BLA approvals by the FDA, 1999-2008
Table 1.3: R&D expenditure by PhRMA members, 1999-2008
Table 4.4: NHI price premium classifications for new drugs
Table 6.5: Pricing across the drug development and marketing lifecycle

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