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Legemiddeløkonomiseminar

Legemiddeløkonomiseminar. Karianne Johansen Legemiddelindustriforeningen, LMI 2 . desember 2010. Topics. Pricing of patented drugs in Norway Experiences with risk sharing policies. Prices compared to our reference countries. Price changes on medicines vs. consumer price index.

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Legemiddeløkonomiseminar

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  1. Legemiddeløkonomiseminar Karianne Johansen Legemiddelindustriforeningen, LMI 2. desember 2010

  2. Topics • Pricing of patented drugs in Norway • Experiences with risk sharing policies

  3. Prices compared to our reference countries

  4. Price changes on medicines vs. consumer price index

  5. 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?

  6. 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

  7. Pharmaceutical expenditure as a percentage of total health expenditure

  8. Risk sharingpolicies Why do we need them? - Handling of uncertainty and share risk • Reimbursement contracts – conditional reimbursement • Performance guaranties - outcome based • Financial models

  9. 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)

  10. 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

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