Analysis of the impact of removing mucolytics and expectorants from the list of reimbursable drugs on prescription rates: A time-series analysis for France 1998–2010

Pichetti, Sylvain; Sorasith, Christine; Sermet, Catherine

doi:10.1016/j.healthpol.2011.07.001

Cited by 11 publications

(4 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore delisting of drugs risks engendering substitution effects; some which may be anticipated while others unexpected and sometimes harmful or expensive. In France, substitution of the delisted drug with a drug from another inadequate therapeutic class was observed after the delisting of expectorants and mucolytics [50]; substitution of phytotherapy used in the treatment of anxiety and insomnia with more expensive and potentially more dangerous psychotropic drugs was observed after the end of phytotherapy reimbursement [51]. Substitution can also take the form of alternative non-pharmaceutical treatments as it was seen after the delisting of phlebotonics in France where an increase of the prescription of support stockings was noticed (Sermet, personal communication).…”

Section: Disinvestment Strategiesmentioning

confidence: 99%

Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review

et al. 2015

Self Cite

View full text Add to dashboard Cite

Pharmaceutical expenditure has increased rapidly across many OECD countries over the past three decades. This growth is an increasing concern for Governments and other third party payers seeking to provide equitable and comprehensive healthcare within sustainable budgets. In order to create headroom for increasing utilisation, and to fund new high cost therapies there is an active push to 'disinvest' from low-value drugs. The aim of this article is to review how reimbursement policy decision makers have sought to partially or completely disinvest from drugs in a range of OECD countries (UK, France, Canada, Australia and New Zealand) where they are publicly funded or subsidised. We employed a systematic literature search strategy and the incorporation of grey literature known to the authorship team. We canvass key policy instruments from each country to outline: key approaches to the identification of candidate drugs for disinvestment assessment (passive approaches versus more active approaches); Methods of disinvestment and value-based purchasing:de-listing, restricting treatment, price or reimbursement rate reductions, encouraging generic prescribing; Lessons learnt from the various approaches; The potential role of coverage with evidence development, and; The need for careful stakeholder management. Dedicated sections are provided with detailed coverage of policy approaches (with drug examples) from each country. Historically countries have relied on 'passive disinvestment', however due to (i) the availability of new costeffectiveness evidence or (ii) 'leakage' in drug utilisation or (iii) market failure in terms of price competition, there is an increasing focus towards 'active disinvestment'. Isolating low-value drugs that would create headroom for innovative new products to enter the market is also motivating disinvestment efforts by multiple parties, including industry. Historically disinvestment has mainly taken the form of price reductions, especially when market failures are perceived to exist, and restricting treatment to sub-populations, particularly when a drug is no longer considered value for money. There is considerable experimentation internationally in mechanisms for disinvestment and the opportunity for countries to learn from each other. Ongoing evaluation of disinvestment strategies is essential, and ought to be reported in the peer-reviewed literature.

show abstract

Section: Disinvestment Strategiesmentioning

confidence: 99%

Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Activities involve generic medicines (46)(47)(48), including ways to obtain low prices for good quality generics as well as increase their utilisation versus originators and patented (single-sourced) products in a class (48)(49)(50)(51)(52) They also involve appraising medicines and other technologies that should be discontinued (53)(54)(55)(56) as well as potentially reviewing funding for the off-label use of medicines where there is robust evidence that they can act as alternatives to patented medicines, e.g. replacing the use of ranibizumab with bevacizumab to treat age-related macular degeneration (57)(58)(59).…”

Section: Introductionmentioning

confidence: 99%

Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Godman

Malmström

Diogène³

et al. 2014

Expert Review of Clinical Pharmacology

Self Cite

116

132

View full text Add to dashboard Cite

Are new models needed to optimise the utilisation of new medicines to sustain healthcare systems?Godman B 1,2,3 , Malmström RE 4 , Diogene E 5 , Gray A 6 , Jayathissa S 7 , Timoney A 8 , Acurcio FA 9,10 , Alkan A 11 , Brzezinska A 12 , Bucsics A 13 , Campbell S 14,15 AbstractIntroduction: Medicines have made an appreciable contribution to improving health. However, even high income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimise their use. Objective: Review case histories among health authorities to improve the utilisation and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. Challenges and proposed models: A number of issues and challenges have been identified including the limited innovation level of new medicines alongside increasing requested prices for their reimbursement especially for oncology, orphan diseases, diabetes and HCV. Models centre on the three pillars of pre-, peri, and post-launch including critical drug evaluation and multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure Discussion: Proposed models which involve all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.

show abstract

“…For example, expectorants and mucolytics, that make coughing up mucus easier and less irritating, were dropped in France from the publicly funded formulary in 2006 as a physician’s prescription was no longer needed. The resulting over-the-counter market for these products saw price increases of up to 200%, the full cost of which was borne by patients leading to affordability issues for those with lower incomes ( 28 ). A second example involved the delisting of phlebotonics for chronic venous diseases in Italy that was followed by an increase in hospitalizations for venous insufficiency ( 29 ).…”

Section: Types Of Health Interventions That May Warrant a Patient-per...mentioning

confidence: 99%

Considering patient perspectives in economic evaluations of health interventions

Fu,

Ng,

Liu

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

Current guidelines for evaluating the cost-effectiveness of health interventions commonly recommend the use of a payer and/or a societal perspective. This raises the concern that the resulting reimbursement decision may overlook the full spectrum of impacts and equity considerations. In this paper, we argue that a potential solution is to supplement a societal- or payer-perspective economic evaluation with an additional evaluation accounting for exclusively the patient perspective. We present five categories of health interventions for which a patient-perspective analysis may be informative including those (1) that cross the definitional boundary between drugs and non-drug technologies; (2) affect patient adherence to protocol; (3) represent revolutionary treatments for genetic disorders; (4) with an incremental cost-effectiveness ratio involving slightly less effective, but substantially less costly, than the current standard; and (5) have been previously approved for funding but now being targeted for potential delisting or disinvestment. Real-world examples are discussed in detail. Lived experience individuals were invited to provide vignettes. Discussions are provided regarding how to incorporate patient inputs to improve patient-centered decision-making.

show abstract

Analysis of the impact of removing mucolytics and expectorants from the list of reimbursable drugs on prescription rates: A time-series analysis for France 1998–2010

Cited by 11 publications

References 27 publications

Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review

Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review

Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Considering patient perspectives in economic evaluations of health interventions

Contact Info

Product

Resources

About