Pharmaceutical Pricing, Reimbursement, and Prescribing News in the First Quarter of 2008 : Market Research Report

Pharmaceutical Pricing, Reimbursement, and Prescribing News in the First Quarter of 2008

Published: Apr. 30, 2008 - 43 Pages

Strategic Considerations; Stakeholder Implications
Overview
United States: New CMS Data on Healthcare and Pharmaceutical Spending Trends; Market Slowdown in 2007; Continued Criticism of Drug Prices; Proposal for Income-Dependent Premiums for Medicare Part D; Calls for Comparative Effectiveness Research; Reductions in Medicare Hospital Outpatient Reimbursement; Delay to Implementation of AMP-Based Reimbursement in Medicaid; Courts Reject Calls for Right of Access to Experimental Drugs
European Union: European Commission Launches Major Antitrust Investigation; Plans to Combat Parallel Trade and Counterfeiting
France: Plans for Healthcare Reform in Summer 2008; Market Trends; Continued Focus on Generics Substitution; Innovation Focused in Oncology and Orphan Diseases
Germany: Plans to Reform the Health Insurance System; Voluntary Rebate Contracts, Cost-Sharing Deals, and Risk-Sharing Agreements; Draft Methodology for Health Economic Evaluation; Future Focus on Costly New Therapies; Impact of Dereimbursement of Nonprescription Medicines
Italy: Signifi cant Reforms in the Finance Act 2008; Sharp Price Increases for Nonprescription Medicines
Spain: Reference Pricing Slows the Growth in Pharmaceutical Expenditures; Court Ruling Strengthens Intellectual Property Protection; Increasing Barriers to Parallel Trade
United Kingdom: Pharmaceuticals Account for a Declining Share of Healthcare Spending; Government Plans to Replace the Pharmaceutical Price Regulation Scheme; Government Response to Parliamentary Review of NICE; Increased Patient Copayments in England
Japan: Limited Changes to the Pricing and Reimbursement System
Outlook and Implications for the Pharmaceutical Industry
Tables: 1. ASMR Ratings of Technologies Assessed in 2007; 2. Select Rebate, Cost-Sharing, and Risk-Sharing Agreements on Branded Drugs in Germany; 3. Changes to the Hierarchy of National Health Insurance Price Premiums in Japan
Figures: 1. U.S. Prescription Drug Expenditures, 1990-2017 (Projected); 2. U.S. Pharmaceutical Expenditures by Source of Funding, 2000-2017 (Projected); 3. Share of U.S. Pharmaceutical Expenditures by Source of Funding, 2000-2017 (Projected); 4. Sales of Prescription Drugs in the United States, 2003-2007; 5. Prescriptions Dispensed in the United States, 2003-2007; 6. Growth Rates for Spending on Select Drug Classes in France, 2007; 7. Distribution of ASMR Ratings Among Technologies Assessed in 2007; 8. Reasons Given to German Statutory Health Insurance Patients for a Change of Prescription Drugs, 2007; 9. Reactions of German Statutory Health Insurance Patients Whose Prescriptions Were Changed, 2007; 10. Average Biennial Price Revisions in Japan, 1994-2008

Abstract

Spending on prescription drugs continues to grow in worldwide markets—but not as fast as other healthcare expenditures. Consequently, the pharmaceutical industry’s relatively modest share of total healthcare costs— less than 15% in most mature markets—is declining in many countries. Yet, despite this trend, governments and other payers continue to focus their cost-cutting strategies on the pharmaceutical market—politically, the least controversial target for economic controls. Government reforms are expected in a number of countries, which will further confound the pharmaceutical industry’s attempts to bring new therapies to market.

Get the Answers You Need to Shape Your Strategy

Recent sales data point to a pronounced slowdown in the world’s leading pharmaceutical markets. How will this trend affect manufacturers’ growth strategies? Which sectors of the market were not affected by slower growth? What factors contributed to the slowdown in the U.S. market? How is the European market expected to manage this downturn?
U.S. healthcare spending is expected to increase steadily over the next 10 years. What revisions in Medicare Part D will be made to control government costs, and what affect will these measures have on the pharmaceutical industry? How will health technology assessment (HTA) initiatives affect the reimbursement system in the United States?
France and Germany are set to introduce major healthcare reforms in 2008. How much government intervention will take hold and will another round of changes be effective? Will mandated use of generics play a role in these reforms? What impact will potential “health evaluation systems” have in the emerging therapies arena?
Pharmaceuticals now account for a declining share of healthcare spending in the United Kingdom. What government actions are expected to replace the current Pharmaceutical Price Regulation Scheme? What kind of reimbursement agreements will manufacturers need to negotiate?

Scope

Issues affecting the pharmaceutical industry in the United States: continued criticism of drug prices; proposal for income-dependent premiums for Medicare Part D; delay in implementation of average manufacturer price (AMP)-based reimbursement in Medicaid.
Issues affecting the pharmaceutical industry in Europe and Japan: plans in 2008 for healthcare reforms in France and Germany; innovation focused on oncology and orphan diseases; reference pricing in Spain slows growth in pharmaceutical expenditures; biennial drug price revisions and a focus on growing the generics market will continue in Japan.
Issues affecting the pharmaceutical industry in the United Kingdom: the Pharmaceutical Price Regulation Scheme will be replaced in September 2008; increased patient copayments in England.

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Pharmaceutical Pricing, Reimbursement, and Prescribing News in the First Quarter of 2008

Table of Contents

Abstract