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The Pricing and Reimbursement Environment for Neurology Drugs

Published by: Decision Resources

Published: Aug. 31, 2009 - 64 Pages


Table of Contents


Executive Summary

Strategic Considerations

Stakeholder Implications

Introduction

International Price Comparisons for Neurology Drugs

Overview

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

Reimbursement Environment

United States

General Environment

Cost-Containment Measures

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

France

General Environment

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

Germany
General Environment

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

Italy
General Environment

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

Spain
General Environment

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

United Kingdom
General Environment

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

Japan
General Environment

Alzheimer’s Disease Therapies

Parkinson’s Disease Therapies

Multiple Sclerosis Therapies

Antiepileptics

Migraine Therapies

Outlook and Implications for the Pharmaceutical Industry

Healthcare Reform in the United States

Increasing Cost-Containment Pressures

Pricing Constraints

Prescribing Restrictions

Greater Use of Generics and Biosimilars

Health Technology Assessment

Innovative Approaches to Pricing and Reimbursement

Key Messages for Payers

Tables

1. Leading Neurology Drugs

2. Ex-Manufacturer Prices of Select Neurology Drugs in Europe and Japan as a Percentage of U.S. Prices, 2008

3. Coverage of Select Neurology Drugs by Leading U.S. Private Insurers and Pharmacy Benefi t Management Companies

4. U.S. Managed Care Organizations’ Use of Select Cost-Containment Measures to Control the Use of Biologic Multiple Sclerosis Therapies

5. Assessment of Select Neurology Drugs by France’s Transparency Commission

6. Timetable for Generics Competition for Leading Neurology Drugs

7. Proposed Topics for U.S. Comparative Effectiveness Research Related to Neurology Drugs

Figures

1. Average Ex-Manufacturer Prices of Neurology Drugs as a Percentage of U.S. Prices, 2008

2. Average Ex-Manufacturer Prices of Alzheimer’s Disease Therapies as a Percentage of U.S. Prices, 2008

3. Average Ex-Manufacturer Prices of Parkinson’s Disease Therapies as a Percentage of U.S. Prices, 2008

4. Average Ex-Manufacturer Prices of Multiple Sclerosis Therapies as a Percentage of U.S. Prices, 2008

5. Average Ex-Manufacturer Prices of Antiepileptics as a Percentage of U.S. Prices, 2008

6. Average Ex-Manufacturer Prices of Migraine Therapies as a Percentage of U.S. Prices, 2008

7. Health Insurance Coverage of the Total U.S. Population, 1997-2007

8. U.S. Residents’ Sources of Prescription Drug Benefi ts, July 2008

9. Sources of Healthcare Funding for U.S. Residents by Neurological Disease, 2008

10. Impact of Antiepileptic Switching on U.S. Patients

11. Average German Retail Prices of Reference-Priced Neurology Drugs as a Percentage of Their Respective Reference Prices, 2009

12. Copayment-Exempt Neurology Drugs in Germany by Compound, July 2009

13. U.S. Managed Care Organizations’ Likelihood of Using Step-Therapy Protocols or Prior Authorization to Promote the Use of Biosimilar Interferon-Beta-1b

14. U.S., French, and German Neurologists’ Anticipated Rates of Adoption for Biosimilar Interferon-Betas

Abstract

Introduction:

Neurological disorders will impose a growing social and financial burden on the major pharmaceutical markets as the elderly population in these countries increases steadily. Governments and other payers recognize the pressing need to tackle these diseases, but they also have to control the relentless growth of healthcare expenditures. In an increasingly cost-conscious reimbursement climate, the pharmaceutical industry must clearly demonstrate the value of neurology drugs.

Get the Answers You Need to Shape Your Strategy:
  • Health technology assessment will increasingly influence coverage of neurology drugs in most markets in the future. What changes are likely in Europe? How will government support for comparative effectiveness research impact the U.S. market?
  • The United States has the highest overall prices of any of the major pharmaceutical markets, but prices for neurology drugs vary widely from country to country. How do European and Japanese prices for bestselling neurology drugs compare with prices in the United States? Which drugs in this therapeutic area are more expensive in Europe and Japan than in the United States?
  • European reimbursement authorities limit access to high-priced neurology drugs. Which agents are key targets for reimbursement restrictions in Europe? What role do health technology assessment bodies play in regulating the use of drugs in this therapeutic area?
  • The Japanese government has not employed the types of cost-containment measures used in the United States and Europe. What is the government considering with regard to the regular price revision process? What are the prospects for long-listed drugs subject to generics competition?
Scope:
  • International price comparisons for neurology drugs: Alzheimer’s disease therapies; Parkinson’s disease therapies; multiple sclerosis therapies; antiepileptics; migraine therapies.
  • Reimbursement environment in the United States, France, Germany, Italy, Spain, the United Kingdom, and Japan: general environment; Alzheimer’s disease therapies; Parkinson’s disease therapies; multiple sclerosis therapies; antiepileptics; migraine therapies.
  • Outlook and implications for the pharmaceutical industry: impact of healthcare reform in the United States; cost-containment trends; prospects for biosimilars; increasing use of health technology assessment; innovative approaches to pricing and reimbursement.


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