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Pricing and Reimbursement of Antivirals
Decision Resources, Inc., June 2010, Pages: 54
Viral infections are a significant public health challenge - and therefore a funding challenge - despite the impressive progress over the last few decades in combating infectious diseases. The research-based pharmaceutical industry has developed a host of treatments for both chronic and acute viral infections. Faced with growing expenditures on these medicines, governments and other payers are struggling to strike a balance between maintaining public health and preserving their finances. Based on the results of a new survey of 100 board-certified U.S. infectious disease specialists, data on funding for drug therapies in the United States, Fingertip Formulary data on coverage patterns for antivirals in the United States, an international comparison of the prices of 33 best-selling branded antivirals, and analysis of the reimbursement environment in Europe and Japan, this report examines the unprecedented challenges that manufacturers of antivirals are likely to face in the coming decade.
Questions answered in this report:
- Prices of branded antivirals vary widely across the world’s major pharmaceutical markets. How do European prices compare with prices in the United States? Which drugs are more expensive in Europe than in the United States? How do prices in Japan compare with U.S. prices?
- The U.S. market generally offers relatively generous reimbursement of antivirals. What are the main sources of funding for antiviral drug therapy in the United States? How do commercial and Medicare plans compare in their coverage of antivirals? What cost-containment measures are in use in the U.S. market?
- A recent survey of U.S. infectious disease specialists found that many of these physicians had concerns regarding their patients’ access to antivirals. To what extent do specialists think that costs and prescribing restrictions limit access to these drugs? What changes in terms of cost-containment are likely in the future? What attributes will have the most significant bearing on new antivirals’ reimbursement prospects?
- European governments are looking to curb their expenditures on high-priced antivirals. How are governments using distribution controls to manage the use of these drugs? What barriers will new antivirals face in the future?
- In Japan, outpatient drugs are generally subject to a patient co payment of 30%. What action has the government taken to ensure that HIV therapies are affordable? What changes to the reimbursement of hepatitis therapies were introduced in April 2010? What assistance is offered with regard to the cost of therapy for respiratory syncytial virus?
Scope of the report
- Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.
- Disease areas covered: HIV/AIDS, hepatitis, herpes infections, influenza, respiratory syncytial virus.
- Primary research: survey of 100 board-certified U.S. infectious disease specialists.
- Sources of funding for drug therapy: analysis of health insurance coverage for major viral diseases in the United States.
- Drug coverage patterns in the United States: Fingertip Formulary on positioning and coverage restrictions of more than 30 best-selling antivirals.
- Data displays: 23 data-rich tables and figures.
Key terms for this report:
Pricing, Reimbursement, Market access, Health technology assessment (HTA), Cost-effectiveness, Cost-containment, Generics, Antiviral, HIV/AIDS, Hepatitis, Herpes, Cytomegalovirus (CMV), Respiratory syncytial virus (RSV), Public health funding, Formulary placement
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