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The European Journal of Health Economics
Published in: The European Journal of Health Economics 6/2019

Open Access 01-08-2019 | Hepatitis C | Original Paper

Accuracy of budget impact estimations and impact on patient access: a hepatitis C case study

Authors: Joost W. Geenen, Cornelis Boersma, Olaf H. Klungel, Anke M. Hövels

Published in: The European Journal of Health Economics | Issue 6/2019

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Abstract

Background

High budget impact (BI) estimates of new drugs limit access to patients due to concerns regarding affordability and displacement effects. The accuracy and methodological quality of BI analyses are often low, potentially mis-informing reimbursement decision making. Using hepatitis C as a case study, we aim to quantify the accuracy of the BI predictions used in Dutch reimbursement decision-making and to characterize the influence of market-dynamics on actual BI.

Methods

We selected hepatitis C direct-acting antivirals (DAAs) that were introduced in the Netherlands between January 2014 and March 2018. Dutch National Health Care Institute (ZIN) BI estimates were derived from the reimbursement dossiers. Actual Dutch BI data were provided by FarmInform. BI prediction accuracy was assessed by comparing the ZIN BI estimates with the actual BI data.

Results

Actual BI, from 1 Jan 2014 to 1 March 2018, was €248 million whilst the BI estimates ranged from €388–€510 million. The latter figure represents the estimated BI for the reimbursement scenario that was adopted, implying a €275 million overestimation. Absent incorporation of timing of regulatory decisions and inadequate correction for the introduction of new products were main drivers of BI overestimation, as well as uncertainty regarding the patient population size and the impact of the final reimbursement decision.

Discussion

BI in reimbursement dossiers largely overestimated actual BI of hepatitis C DAAs. When BI analysis is performed according to existing guidelines, the resulting more accurate BI estimates may lead to better informed reimbursement decisions.
Appendix
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Metadata
Title
Accuracy of budget impact estimations and impact on patient access: a hepatitis C case study
Authors
Joost W. Geenen
Cornelis Boersma
Olaf H. Klungel
Anke M. Hövels
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Keyword
Hepatitis C
Published in
The European Journal of Health Economics / Issue 6/2019
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-019-01048-z

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