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Published in: The European Journal of Health Economics 8/2018

01-11-2018 | Editorial

Pharmaceutical pricing conundrum: time to get rid of it?

Authors: Livio Garattini, Anna Padula

Published in: The European Journal of Health Economics | Issue 8/2018

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Excerpt

A basic concept of economics is that a price stems from the intersection between supply and demand curves in any common market. However, there are markets where consumers do not pay for goods directly, like in healthcare, and prescription drugs are a well-known example. Not by chance called ‘ethical drugs’, their importance for patients’ health makes them ‘merit goods’ regulated beyond the common laws of the market [1]. Ethical drugs are mostly prescribed by physicians to patients and funded by public expenditure in highly developed countries, such as Western European ones, characterized by well-established welfare systems. Accordingly, price regulation schemes have long been an unavoidable policy response to control public pharmaceutical expenditure [2]. …
Footnotes
1
For instance, 18 therapeutic classes could be set, based on the first level of the ICD and matched with the first level of the ATC classification.
 
2
For instance, a 50% decrease after patent expiry could be reasonable for patenting, while manufacturing would require a survey to estimate an average difference for the two types of drugs. Assuming a hypothetical difference of + 20% for manufacturing biologics, the other three weights would range from 0.5 for a chemical generic to 1.2 for an on-patent biologic, with an intermediate value of 0.6 for biosimilars.
 
3
For instance, national authorities could reimburse pharmaceutical firms on a monthly basis, applying the unit costs of each therapeutic class weighed for the four types of products (see previous footnote), and the unit costs per dose should be proportionally decreased/increased every quarter.
 
Literature
1.
go back to reference Garattini, L., Padula, A.: Competition in pharmaceuticals: more product-than price-oriented? Eur. J. Health Econ. 19(1), 1–4 (2018)CrossRef Garattini, L., Padula, A.: Competition in pharmaceuticals: more product-than price-oriented? Eur. J. Health Econ. 19(1), 1–4 (2018)CrossRef
2.
go back to reference Garattini, L., Curto, A., Freemantle, N.: Pharmaceutical price schemes in Europe: time for a ‘continental’ one? Pharmacoeconomics 34(5), 423–426 (2016)CrossRef Garattini, L., Curto, A., Freemantle, N.: Pharmaceutical price schemes in Europe: time for a ‘continental’ one? Pharmacoeconomics 34(5), 423–426 (2016)CrossRef
3.
go back to reference Garattini, L., Padula, A.: Between pharmaceutical patents and European patients: is a compromise still possible? Expert Opin. Ther. Pat. 27(10), 1073–1076 (2017)CrossRef Garattini, L., Padula, A.: Between pharmaceutical patents and European patients: is a compromise still possible? Expert Opin. Ther. Pat. 27(10), 1073–1076 (2017)CrossRef
4.
go back to reference Garattini, L., Cornago, D., De Compadri, P.: Pricing and reimbursement of in-patent drugs in seven European countries: a comparative analysis. Health Policy 82(3), 330–339 (2007)CrossRef Garattini, L., Cornago, D., De Compadri, P.: Pricing and reimbursement of in-patent drugs in seven European countries: a comparative analysis. Health Policy 82(3), 330–339 (2007)CrossRef
5.
go back to reference Garattini, L., Casadei, G.: Health technology assessment: for whom the bell tolls? Eur. J. Health Econ. 9(4), 311–312 (2008)CrossRef Garattini, L., Casadei, G.: Health technology assessment: for whom the bell tolls? Eur. J. Health Econ. 9(4), 311–312 (2008)CrossRef
6.
go back to reference Garattini, L., Padula, A.: Dutch guidelines for economic evaluation: ‘from good to better’ in theory but further away from pharmaceuticals in practice? J. R. Soc. Med. 110(3), 98–103 (2017)CrossRef Garattini, L., Padula, A.: Dutch guidelines for economic evaluation: ‘from good to better’ in theory but further away from pharmaceuticals in practice? J. R. Soc. Med. 110(3), 98–103 (2017)CrossRef
7.
go back to reference Brooks, E., Geyer, R.: Can a medical need clause help manage the growing costs of prescription drugs in the EU? Health Econ. Policy Law 11(2), 179–192 (2016)CrossRef Brooks, E., Geyer, R.: Can a medical need clause help manage the growing costs of prescription drugs in the EU? Health Econ. Policy Law 11(2), 179–192 (2016)CrossRef
8.
go back to reference Curto, S., Ghislandi, S., van de Vooren, K., Duranti, S., Garattini, L.: Regional tenders on biosimilars in Italy: an empirical analysis of awarded prices. Health Policy 116(2), 182–187 (2014)CrossRef Curto, S., Ghislandi, S., van de Vooren, K., Duranti, S., Garattini, L.: Regional tenders on biosimilars in Italy: an empirical analysis of awarded prices. Health Policy 116(2), 182–187 (2014)CrossRef
9.
go back to reference Van der Gronde, T.V., Uyl-de Groot, C.A., Pieters, T.: Addressing the challenge of high-priced prescription drugs in the era of precision medicine: a systematic review of drug life cycles, therapeutic drug markets and regulatory frameworks. PLoS One 12(8), e0182613 (2017)CrossRef Van der Gronde, T.V., Uyl-de Groot, C.A., Pieters, T.: Addressing the challenge of high-priced prescription drugs in the era of precision medicine: a systematic review of drug life cycles, therapeutic drug markets and regulatory frameworks. PLoS One 12(8), e0182613 (2017)CrossRef
10.
go back to reference Garattini, L., Curto, A.: Performance-based agreements in Italy: ‘Trendy Outcomes’ or Mere illusions? Pharmacoeconomics 34(10), 967–969 (2016)CrossRef Garattini, L., Curto, A.: Performance-based agreements in Italy: ‘Trendy Outcomes’ or Mere illusions? Pharmacoeconomics 34(10), 967–969 (2016)CrossRef
11.
go back to reference Garattini, L., Curto, A., Padula, A.: Reimbursable drug classes and ceilings in Italy: why not only one? Eur. J. Health Econ. 17(8), 923–926 (2016)CrossRef Garattini, L., Curto, A., Padula, A.: Reimbursable drug classes and ceilings in Italy: why not only one? Eur. J. Health Econ. 17(8), 923–926 (2016)CrossRef
12.
go back to reference Garattini, L., Padula, A.: ‘Appropriateness’ in Italy: a ‘Magic Word’ in pharmaceuticals? Appl. Health Econ. Health Policy 15(1), 1–3 (2017)CrossRef Garattini, L., Padula, A.: ‘Appropriateness’ in Italy: a ‘Magic Word’ in pharmaceuticals? Appl. Health Econ. Health Policy 15(1), 1–3 (2017)CrossRef
13.
go back to reference van de Vooren, K., Curto, A., Garattini, L.: Optional copayments on anti-cancer drugs. BMJ 346, f349 (2013)CrossRef van de Vooren, K., Curto, A., Garattini, L.: Optional copayments on anti-cancer drugs. BMJ 346, f349 (2013)CrossRef
14.
go back to reference Frakt, A.B., Chernew, M.E.: The importance of relative prices in health care spending. JAMA 319(5), 441–442 (2018)CrossRef Frakt, A.B., Chernew, M.E.: The importance of relative prices in health care spending. JAMA 319(5), 441–442 (2018)CrossRef
15.
go back to reference Reinhardt, U.: Probing our moral values in health care: the pricing of specialty drugs. JAMA 314(10), 981–982 (2015)CrossRef Reinhardt, U.: Probing our moral values in health care: the pricing of specialty drugs. JAMA 314(10), 981–982 (2015)CrossRef
16.
go back to reference Levy, M., Rizansky, N.A.: The pricing of breakthrough drugs: theory and policy implications. PLoS One 9(11), e113894 (2014)CrossRef Levy, M., Rizansky, N.A.: The pricing of breakthrough drugs: theory and policy implications. PLoS One 9(11), e113894 (2014)CrossRef
17.
go back to reference Wirtz, V.J., Hogerzeil, H.V., Gray, A.L., Bigdeli, M., de Joncheere, C.P., Ewen, M.A., et al.: Essential medicines for universal health coverage. Lancet 389(10067), 403–476 (2016)CrossRef Wirtz, V.J., Hogerzeil, H.V., Gray, A.L., Bigdeli, M., de Joncheere, C.P., Ewen, M.A., et al.: Essential medicines for universal health coverage. Lancet 389(10067), 403–476 (2016)CrossRef
18.
go back to reference Moors, E.H., Cohen, A.F., Schellekens, H.: Towards a sustainable system of drug development. Drug Discov Today 19(11), 1711–1720 (2014)CrossRef Moors, E.H., Cohen, A.F., Schellekens, H.: Towards a sustainable system of drug development. Drug Discov Today 19(11), 1711–1720 (2014)CrossRef
19.
go back to reference Prasad, V., Mailankody, S.: Research and development spending to bring a single cancer drug to market and revenues after approval. JAMA Intern Med 177(11), 1569–1575 (2017)CrossRef Prasad, V., Mailankody, S.: Research and development spending to bring a single cancer drug to market and revenues after approval. JAMA Intern Med 177(11), 1569–1575 (2017)CrossRef
20.
go back to reference Lexchin, J.: The relation between promotional spending on drugs and their therapeutic gain: a cohort analysis. CMAJ Open 5(3), E724–E728 (2017)CrossRef Lexchin, J.: The relation between promotional spending on drugs and their therapeutic gain: a cohort analysis. CMAJ Open 5(3), E724–E728 (2017)CrossRef
21.
go back to reference Chandra, A., Garthwaite, C.: The economics of indication-based drug pricing. N. Engl. J. Med. 377(2), 103–106 (2017)CrossRef Chandra, A., Garthwaite, C.: The economics of indication-based drug pricing. N. Engl. J. Med. 377(2), 103–106 (2017)CrossRef
22.
go back to reference Dolgin, E.: Bringing down the cost of cancer treatment. Nature 555(7695), S26–S29 (2018)CrossRef Dolgin, E.: Bringing down the cost of cancer treatment. Nature 555(7695), S26–S29 (2018)CrossRef
23.
go back to reference Gagnon, M.A., Volesky, K.D.: Merger mania: mergers and acquisitions in the generic drug sector from 1995 to 2016. Glob. Health 13(1), 62 (2017)CrossRef Gagnon, M.A., Volesky, K.D.: Merger mania: mergers and acquisitions in the generic drug sector from 1995 to 2016. Glob. Health 13(1), 62 (2017)CrossRef
24.
go back to reference Garattini, L., Curto, A.: European medicines agency: leave the UK but remain the same? JRSM 109(9):324–325 (2016)CrossRef Garattini, L., Curto, A.: European medicines agency: leave the UK but remain the same? JRSM 109(9):324–325 (2016)CrossRef
25.
go back to reference Garattini, L., Curto, A., Padula, A.: The puzzle of drug delivery in Italy: who wins? Expert Rev. Pharmacoecon. Outcomes Res. 16(3), 331–332 (2016)CrossRef Garattini, L., Curto, A., Padula, A.: The puzzle of drug delivery in Italy: who wins? Expert Rev. Pharmacoecon. Outcomes Res. 16(3), 331–332 (2016)CrossRef
26.
go back to reference Ploumen, L., Schippers, E.: Better life through medicine—let’s leave no one behind. Lancet 389(10067), 339–341 (2017)CrossRef Ploumen, L., Schippers, E.: Better life through medicine—let’s leave no one behind. Lancet 389(10067), 339–341 (2017)CrossRef
Metadata
Title
Pharmaceutical pricing conundrum: time to get rid of it?
Authors
Livio Garattini
Anna Padula
Publication date
01-11-2018
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue 8/2018
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-018-0995-x

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