Abstract
Introduction:
Implementation and refinement of existing pricing and reimbursement
initiatives throughout the major pharmaceutical markets continued to be a
major theme in the fourth quarter of 2006. In the United States, preparations
continued for the second year of the Medicare Part D prescription drug
benefit. In Europe, while the European Union took action to promote common
standards for health technology assessment, individual governments continued
to pursue independent national cost-containment strategies. And in Japan,
implementation of revised price premiums earlier in the year has benefited
manufacturers of useful and innovative drugs.
Get the Answers You Need to Shape Your Strategy:
- In the United States, the midterm Congressional elections dominated the
news. What implications will this change of power have on U.S. health care
policy? How will the pharmaceutical and biotechnology industries respond to
this new political landscape?
- The German government has proposed significant health care reforms. How
will these reforms affect health insurance, physician reimbursement,
hospitals, and the pharmaceutical market? What new freedoms and what new
constraints will result?
- Governments in the major pharmaceutical markets continue to refine
regulations on drug pricing and reimbursement. How will these refinements
affect the pharmaceutical markets in these countries? Will certain drug
classes in certain countries actually benefit from these reforms?
- The steady expansion of reference pricing across Europe exemplifies
governments' tendency to imitate each other, while they simultaneously pursue
their disparate national strategies for containing health care costs. In
such a climate, is there any hope for harmonized reimbursement standards?
Scope:
- Fourth quarter news in 2006: major events in the pharmaceutical
pricing, reimbursement, and prescribing environment in the United States,
Europe (France, Germany, Italy, Spain, and the United Kingdom), and Japan.
- Cost-containment programs: measures that health care payers are
using to curb their drug expenditures and to improve patient access to
medications.
- Outlook: our assessment of the implications of these events for the
pharmaceutical industry in the major markets under study.
Mentioned in This Spectrum Report:
Organizations:
- Agence Francaise de Sécurité
- Sanitaire des Produits de Santé (AFSSAPS; French Agency for the
Safety of Health Products)
- Allgemeine Ortskrankenkassen (Local General Health Insurance Funds)
- Biotechnology Industry Organization (BIO)
- Bundesfachverband der Arzneimittelhersteller(BAH; Federal Association of
Pharmaceutical Manufacturers)
- Bundesverband der Betriebskrankenkassen (BKK;Federal Association of
Occupational Health Insurance Funds)
- Bundesvereinigung Deutscher Apothekerverbande(ABDA; Federal Union of
German Pharmacists' Associations)
- Centers for Medicare and Medicaid Services (CMS)
- Chuikyo (Central Social Insurance Medical Council)
- Department of Veterans Affairs (VA)
- European Network for Health Technology Assessment (HTA)
- Farmaindustria Gemeinsamer Bundesausschus der Ärzte,Zahnärzte,
Krankenhäuser und Krankenkassen(GBA; Joint Federal Committee of
Physicians, Dentists, Hospitals, and Health Insurance Funds)
- Gesetzliche Krankenversicherung (GKV; statutory health insurance)
- Haute Autorité de Santé (HAS; National Health Authority)
- High-Level Group on Innovation and the Provision of Medicines (G10
Medicines Group)
- High-Level Pharmaceutical Forum
- House Energy and Commerce Committee' s Subcommittee on Health
- Institut
für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG;
Institute for Quality and Economy in the Health Care System)
- Kassenärztliche Bundesvereinigung (KBV; Federal Union of Health
Insurance Fund Physicians)
- National Health Service (NHS)
- National Institute for Health and Clinical Excellence (NICE)
- Osservatorio Nazionale sull' Impiego dei Medicinali (OsMed; National
Observatory on Pharmaceutical Spending)
- Servizio Sanitario Nazionale (SSN; National Health Service)
- Sistema Nacional de Salud (SNS; National Health System)
Companies:
- EnvisionRx Plus
- Express Scripts
- First Databank
- Health Net
- Humana
- Ipsen
- Longs Drug Stores
- McKesson
- Medi-Span
- Merck KGaA
- NewQuest Health Solutions
- NMHC Systems
- Roche
- Thomson' s Red Book
- Torchmark
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