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Explore the nuances of pricing patented drugs in Norway, the impact of risk sharing policies, and international comparisons. Delve into the challenges of proper pricing that rewards innovation, meets stakeholder needs, and ensures patient outcomes. Understand the importance of predictability, transparency, and societal value recognition.
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Legemiddeløkonomiseminar Karianne Johansen Legemiddelindustriforeningen, LMI 2. desember 2010
Topics • Pricing of patented drugs in Norway • Experiences with risk sharing policies
International reference pricing • Do all countries in the basket have the same characteristics? • Ad-hoc cuts enforced due to i.e. financial crisis • Affordability? • Disease burden in Norway? • Fluctuations in exchange rates? • Does it reward value of the product in a correct manner?
Proper pricing system should • Adequately reward innovation • Both pricing and reimbursement mechanism • Predictable and transparent • Allow rapid access and meet the need of all stakeholders • Focus on patient outcome and quality of care
Pharmaceutical expenditure as a percentage of total health expenditure
Risk sharingpolicies Why do we need them? - Handling of uncertainty and share risk • Reimbursement contracts – conditional reimbursement • Performance guaranties - outcome based • Financial models
Underlying models similar, but differ in reimbursement price and scheme Financial Utilization Models Outcomes Based Pricing Models Risk Based Pricing Models Tx Value Initial 10% of patients Full response High Risk Next 20% of patients Partial response Moderate risk All others No response Low risk Patient segments Patient segments Patient segments • Price Volume Agreement: e.g. full reimbursement for first 10% of patients, reduced reimbursement for next 20% of patients, no reimbursement for all others • Money back guarantee, e.g. full reimbursement for responders, reduced reimbursement for partial responders, no reimburse-ment for non-responders • Reimbursement linked to value and level of risk (e.g. based on diagnostic test)
Our viewpoints • Innovation should be rewarded • Both pricing and reimbursement mechanism • Allow rapid access and meet the need of all stakeholders • Societal value must be recognized • Silo budgeting should be avoided • Focus on patient outcome and quality of care