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Pharmaceutical Pricing, Reimbursement, and Prescribing News in the Fourth Quarter of 2006

Published by: Decision Resources

Published: Mar. 8, 2007 - 22 Pages

The price of this report has been reduced due to its age. The original price was $2,025 for PDF.

Table of Contents



Executive Summary

Strategic Considerations

Stakeholder Implications

Introduction

United States

Impact of Congressional Elections

Changes to Medicare Part D

Medicaid Reform

Average Wholesale Price Measure Under Threat

European Union

European Cooperation on Health Technology Assessment

France

New Wave of Reimbursement Cuts

Impact of Government’s Medical Control Strategy

Germany

Slowdown in Pharmaceutical Spending

Proposed New Health Care Reforms

Daily Cost-of-Therapy Limits

Many Products Exempted from Copayments

Reference Price Adjustments for 2007

Italy

Price Cuts Slow Sales Growth

Spain

Industry Requests Price Increase

New Reference Pricing System Authorized

United Kingdom

Clarification of NICE’s Role in the National Health Service

Courts Rule on Access to Drugs Rejected by NICE

Japan

Reform of the Pricing and Reimbursement System Deferred

Higher Price Premiums for Innovation

Outlook and Implications for the Pharmaceutical Industry



Tables:

1: Key Features of Standard Medicare Part D Drug Benefit, 2006 and 2007

2: German Daily Cost-of-Therapy Limits, 2007



Figures:

1: Percentage of Stand-Alone Prescription Drug Plans Charging Various Monthly Premiums,

2006 and 2007

2: Percentage of Medicare Advantage Plans Charging Various Monthly Drug Premiums,

2006 and 2007

3: Percentage of Stand-Alone Prescription Drug Plans Levying Various Drug Deductibles,

2006 and 2007

4: Percentage of Medicare Advantage Plans Levying Various Drug Deductibles, 2006

and 2007

5: Percentage of Stand-Alone Prescription Drug Plans Offering Various Levels of Drug

Coverage in the Coverage Gap, 2006 and 2007

6: Percentage of Medicare Advantage Plans Offering Various Levels of Drug Coverage in

the Coverage Gap, 2006 and 2007

7: Monthly Pharmaceutical Expenditures of Germany’s Statutory Health Insurance System,

January 2003-October 2006

8: Influences on Pharmaceutical Expenditures in Germany’s Statutory Health Insurance

System, April-October 2006

Abstract

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?

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