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The Challenges of Reference Pricing in Europe

Published by: Decision Resources

Published: May. 28, 2007 - 28 Pages


Table of Contents


Executive Summary

Strategic Considerations

Stakeholder Implications

Introduction

Germany

Extension of Reference Pricing to Patent-Protected Drugs

A More Aggressive Reference Price Method

Incentives to Undercut Reference Prices

Price Adjustments in 2007

Market Impact

Netherlands

Spain

Italy

France

Outlook and Implications for the Pharmaceutical Industry

Sidebars

The Impact of Generics Competition and Reference Pricing on the German

Statin Market—A Cautionary Tale

To Cut or Not to Cut—The Pros and Cons of Reference Price Alignment

German Physicians’ Views on Reference Pricing—Lessons from the Statin

Market

Tables

1. Out-of-Pocket Payments for Reference-Priced Drugs in Germany

2. Cumulative Savings from Reference Pricing in Germany, 1989-2007

3. Penetration of Reference-Priced Drugs into the German Pharmaceutical Market, 2004-2006

4. Drugs Exceeding Their Reference Prices in France (June 1, 2005)

Figures

1. Reference-Priced Drugs in Germany: Percentage of Drugs with Retail Prices Above, In Line With, and Below Their Respective Reference Prices (January 1, 2007)

2. Total Sales and Prescription Shares of Reference-Priced Drugs in the German Statutory Health Insurance Pharmaceutical Market, 1999-2005

3. Reference-Priced Drugs in Spain: Overall Relationship Between Drug Prices and Their Reference Prices

A. Consumption of Statins in the German Statutory Health Insurance Market, 2001-2005

B. Proton Pump Inhibitors in the German Statutory Health Insurance Pharmaceutical Market: Percentage Change in Price, Prescribing Volume, and Sales (2004-2005)

C. Sartans in the German Statutory Health Insurance Pharmaceutical Market: Percentage Change in Price, Prescribing Volume, and Sales (2004-2005)

D. Has Reference Pricing Created a Two-Class System for the Treatment of Dyslipidemia in Germany? (Physician Responses)

E. Physician Views of Actions Taken by GKV Patients Prescribed Atorvastatin in 2005

Abstract

In 1989, the German government introduced reference pricing as a cost-containment strategy for the pharmaceutical industry’s high prices of drugs. Now, much of Europe employs reference pricing as a means to rein in the prices of prescription drugs. Pharmaceutical companies have been forced to decide whether to cut their prices in order to match reference prices, or maintain higher prices—thereby gambling that the money lost due to lower prescribing volumes will be more than offset by the money gained by the price. Meanwhile, patients have been caught in a web of new pricing systems that may be creating a two-class system of health care.

Get the Answers You Need to Shape Your Strategy:
The German government recently began waiving patients’ out-of-pocket payments on thousands of pharmaceutical products. Which category of drugs could be severely disadvantaged by these waivers?

In 2004, Pfi zer denounced Germany’s GBA for including patent-protected medicines in “jumbo” reference pricing groups, thereby subjecting Sortis (atorvastatin) to reference prices. What pricing strategy did Pfizer ultimately use to defend Sortis? What was the effect of Pfi zer’s strategy on Sortis’s market share?

Regional governments in Italy have some discretion when deciding reimbursement terms for reference-priced medicines. Why has the Italian Drugs Agency recently expressed concern that some regions in Italy may be abusing their discretionary privilege?

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