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This paper describes pharmaceutical pricing and reimbursement policies in Germany, considering them in the broader environment in which they operate, and assesses their impact on the achievement of a number of policy goals. Pharmaceutical coverage is comprehensive, with a high level of public funding, and ensures access to treatments. However, recent increases in out-of-pocket payments may impair affordability for the poorest part of the population. Germany does not regulate ex-manufacturer prices of pharmaceuticals at market entry (though distribution margins are regulated for reimbursed drugs). On the other hand, maximum reimbursement amounts (known as reference prices) are set for products which can be clustered in groups of equivalent (generic) or comparable products (...)
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This study analyses how 14 OECD Countries refer to “value” when making decisions on reimbursement and prices of new medicines. It details the type of outcomes considered, the perspective and methods adopted for economic evaluation when used; and the consideration of budget impact. It describes which dimensions are taken into account in the assessment of “innovativeness” and the consequences of this assessment on prices; it confirms that treatments for severe and/or rare diseases are often more valued than others and shows how countries use product-specific agreements in an attempt to better align value and price.
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This paper describes and assesses pharmaceutical pricing and reimbursement policies in Canada, considering them in the context of the broader policy and market environment in which they operate, and investigating their role in contributing to Canada’s achievements in meeting a range of objectives relating to the pharmaceutical policy. The federal government regulates prices of patented pharmaceutical products with the objective of protecting consumers against excessive prices. Regulation has very likely been responsible for bringing Canada’s prices for patented medicines roughly in line with European comparators. Prices of generic products, which are not regulated, are relatively high although high...
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This paper examines aspects of the policy environment and market characteristics of the Swiss pharmaceutical sector, and assesses the degree to which Switzerland has achieved certain policy goals. In Switzerland, pharmaceutical spending has not been growing faster than health expenditure as a whole, as has been the case in many other OECD countries. Swiss pharmaceutical spending per capita and as a share of GDP is modest by OECD standards. This in part reflects relatively low levels of pharmaceutical consumption, given that public prices are among the highest in Europe and the Swiss tend to be early adopters of new pharmaceutical products. Switzerland’s regulation of prices for reimbursed drugs, based on referencing across countries and within the therapeutic class for products with comparators, appears to result in prices lower than what would be obtained absent regulation. Although ex-manufacturer prices are somewhat high relative to other European countries, recent reforms have reduced the differential. While costs are under control, Switzerland has scope to improve the cost-effectiveness of its expenditures in the pharmaceutical area. Generic penetration of the market is increasing but falls short of what has been achieved elsewhere and the prices of generic products are higher than what is found in other countries. Relatively high mark-ups over ex-factory prices suggest that the distribution chain is a source of further potential efficiencies, although high costs could also reflect characteristics of the Swiss economy...
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This study analyses how 14 OECD Countries refer to "value" when making decisions on reimbursement and prices of new medicines. It details the type of outcomes considered, the perspective and methods adopted for economic evaluation when used; and the consideration of budget impact. It describes which dimensions are taken into account in the assessment of "innovativeness" and the consequences of this assessment on prices; it confirms that treatments for severe and/or rare diseases are often more valued than others and shows how countries use product-specific agreements in an attempt to better align value and price.
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This paper describes pharmaceutical pricing and reimbursement policies in Germany, considering them in the broader environment in which they operate, and assesses their impact on the achievement of a number of policy goals. Pharmaceutical coverage is comprehensive, with a high level of public funding, and ensures access to treatments. However, recent increases in out-of-pocket payments may impair affordability for the poorest part of the population. Germany does not regulate ex-manufacturer prices of pharmaceuticals at market entry (though distribution margins are regulated for reimbursed drugs). On the other hand, maximum reimbursement amounts (known as reference prices) are set for products which can be clustered in groups of equivalent (generic) or comparable products (...)
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This study analyses how 14 OECD Countries refer to “value” when making decisions on reimbursement and prices of new medicines. It details the type of outcomes considered, the perspective and methods adopted for economic evaluation when used; and the consideration of budget impact. It describes which dimensions are taken into account in the assessment of “innovativeness” and the consequences of this assessment on prices; it confirms that treatments for severe and/or rare diseases are often more valued than others and shows how countries use product-specific agreements in an attempt to better align value and price.
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This paper examines aspects of the policy environment and market characteristics of the Swiss pharmaceutical sector, and assesses the degree to which Switzerland has achieved certain policy goals. In Switzerland, pharmaceutical spending has not been growing faster than health expenditure as a whole, as has been the case in many other OECD countries. Swiss pharmaceutical spending per capita and as a share of GDP is modest by OECD standards. This in part reflects relatively low levels of pharmaceutical consumption, given that public prices are among the highest in Europe and the Swiss tend to be early adopters of new pharmaceutical products. Switzerland’s regulation of prices for reimbursed drugs, based on referencing across countries and within the therapeutic class for products with comparators, appears to result in prices lower than what would be obtained absent regulation. Although ex-manufacturer prices are somewhat high relative to other European countries, recent reforms have reduced the differential. While costs are under control, Switzerland has scope to improve the cost-effectiveness of its expenditures in the pharmaceutical area. Generic penetration of the market is increasing but falls short of what has been achieved elsewhere and the prices of generic products are higher than what is found in other countries. Relatively high mark-ups over ex-factory prices suggest that the distribution chain is a source of further potential efficiencies, although high costs could also reflect characteristics of the Swiss economy...
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This paper describes and assesses pharmaceutical pricing and reimbursement policies in Canada, considering them in the context of the broader policy and market environment in which they operate, and investigating their role in contributing to Canada’s achievements in meeting a range of objectives relating to the pharmaceutical policy. The federal government regulates prices of patented pharmaceutical products with the objective of protecting consumers against excessive prices. Regulation has very likely been responsible for bringing Canada’s prices for patented medicines roughly in line with European comparators. Prices of generic products, which are not regulated, are relatively high although high...
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