Pharmaceutical Pricing, Reimbursement, and Prescribing News in the First Quarter of 2007

Published by: Decision Resources

Published: May. 3, 2007 - 23 Pages

Table of Contents

Executive Summary

Strategic Considerations

Stakeholder Implications

Introduction

United States

Slowdown in U.S. Health Care Spending in 2005

Solid Growth in U.S. Pharmaceutical Market in 2006

Increased Scrutiny of Drug Prices for Federal Programs

Continued Growth in Medicare Part D Enrollment

Pressure for Government Price Negotiations for Medicare Part D

Prospect of Increased Medicaid Rebates

Measures to Improve Access to Generic Drugs

Regulation of Biogenerics

Drug Importation

France

National Frame of Reference for the Good Use of Expensive and Innovative Drugs

Parallel Imports

Obesity Therapy Qualifi es for Limited Reimbursement

GlaxoSmithKline Fined for Predatory Pricing

Germany

Slowdown in Pharmaceutical Spending

New Health Care Reforms Enacted

Growth of Manufacturer Rebates

Daily Cost-of-Therapy Limits

Italy

Concern over Regional Reference Pricing Initiatives

Industry Calls for a Change in Pharmaceutical Policy

Spain

Implementation of New Reference Pricing System

New System to Monitor Parallel Exports

United Kingdom

Proposal to Replace the Pharmaceutical Price Regulation Scheme

New Candidates for Single Technology Appraisals

Adjustments to Prescription Charges

Japan

Expected Reform of the Pricing and Reimbursement System

Limited Level of Generics Substitution

Outlook and Implications for the Pharmaceutical Industry

Figures

1. Evolution of Prescription Drug Expenditures in the United States in Select Years from 1970 to 2005

2. Main Sources of Funding for U.S. Prescription Drug Expenditures, 2005

3. Medicare Benefi ciaries’ Prescription Drug Coverage, January 2007

Abstract

• In January 2007, U.S. lawmakers proposed a series of bills to improve U.S. consumers’ access to lowpriced generic drugs, including biogenerics. Which bills have been proposed, how much savings are they purported to offer, and what are their chances of being made into law?
• According to the Centers for Medicare and Medicaid Services, the Medicare Part D prescription drug benefit is saving benefi ciaries an average of $1,200 per year. On January 12, 2007, in a further attempt to lower drug prices, the House of Representatives passed the Medicare Prescription Drug Price Negotiation Act of 2007, which would empower the Department of Health and Human Services to negotiate Medicare Part D drug prices. What is the Congressional Budget Office’s argument against this proposal?
• In February 2007, the United Kingdom’s Offi ce of Fair Trading (OFT) published a highly critical review of the Pharmaceutical Price Regulation Scheme, which controls the level of profi t companies may make on sales of branded prescription drugs to the National Health Service. What were the OFT’s criticisms, and what two options did the agency propose to better control prescription drug prices?
• The announcement, in March 2007, by Japan’s Ministry of Health, Labor, and Welfare that it is considering overhauling the national pricing and reimbursement system has galvanized the international pharmaceutical industry, which has long been critical of the system. What reforms is the Federation of Pharmaceutical Manufacturers’ Associations of Japan planning to propose?

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