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Pricing and Reimbursement Issues in Psychiatry

Published by: Decision Resources

Published: Dec. 21, 2006 - 44 Pages

Price reduced due to age.

Table of Contents


Executive Summary Strategic Considerations

Stakeholder Implications

Introduction

International Price Comparisons of Psychiatric Drugs Overview

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

Reimbursement Environment

United States

General Environment

Private Insurance

Medicare

Sidebar: Patient Assistance Programs—An Important Source of Drug Funding

Medicaid

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

France

General Environment

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

Germany

General Environment

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

Italy

General Environment

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

Spain

General Environment

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

United Kingdom

General Environment

Antidepressants

Antipsychotics

Psychostimulants

Hypnotics, Sedatives, and Anxiolytics

Abstract

Compared with many other disease areas (e.g., cancer, immune diseases), the costs of drug therapy for psychiatric disorders are relatively modest. However, the World Health Organization forecasts that by 2020, depression—just one of a spectrum of psychiatric disorders—will be the second most frequent cause of death and disability in the world and the leading cause in industrialized nations. In anticipation of this surge, payers in the major pharmaceutical markets would like to exercise greater control over the use of psychiatric drugs.

Get the Answers You Need to Shape Your Strategy
In just the major pharmaceutical markets, the number of people afflicted with common psychiatric disorders will increase, and spending on drug therapies will grow steadily. How will payers try to curb spending on psychiatric drugs? The prices of generic antidepressants are much higher in Europe than in the United States.

What factors are behind this differential?
Pharmacy benefits offered by U.S. private insurers tend to be considerably more generous than the coverage provided by Medicare and Medicaid, but cost-containment measures are proliferating. What steps are private insurers taking to control drug expenditures?

Medicare Part D offers outpatient drug coverage to all Medicare beneficiaries who choose to enroll. What will be the standard benefi t design of Part D in 2007?

The U.S. Medicaid program is a major source of funding for psychiatric drugs—especially atypical antipsychotics. What cost-cutting measures are state Medicaid programs instituting to control drug expenditures?

France has the lowest average prices of any of the major pharmaceutical markets for branded antidepressants. Nevertheless, the government would like to reduce spending on this drug class. What steps has the Caisse Nationale de l’Assurance Maladie taken to stimulate France’s relatively immature generics market? How successful have these measures been so far?

Scope
Drug classes covered: antidepressants, antipsychotics, psychostimulants, hypnotics, sedatives, and anxiolytics.
Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan. Price comparisons: comparisons of international pricing of the psychiatric drug classes in this report.
Reimbursement: overview of the general environment in each market and analysis of factors specifi c to individual psychiatric drug classes. Market outlook: pricing and reimbursement implications for the manufacturers of psychiatric drugs.

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