Cost Containment Through Pharmaceutical Procurement: A Caribbean Case Study

Huff-Rousselle, Maggie; Burnett, Francis Lowell

doi:10.1002/(sici)1099-1751(199604)11:2<135::aid-hpm422>3.3.co;2-t

Cited by 11 publications

(29 citation statements)

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“…The present study concurs with other studies indicating that pooled procurement was a successful means of pharmaceutical cost containment [12–16]. Over time, however, declining compliance with contracts could reduce savings.…”

Section: Discussionsupporting

confidence: 92%

“…Two main approaches have been used in an attempt to control this growth, i.e., supply‐side management, and demand‐side management [2–5]. Supply‐side management focuses on negotiations with vendors and may include price control, profit control, pooled procurement, rebates, reference pricing, expenditure ceilings, or positive/negative lists [5–16]. Demand‐side management focuses on the management of utilization of pharmaceuticals by prescribers and patients and may include educational campaigns, prescribing guidelines, patient copayments, switching prescription medicines to over‐the‐counter medicines, promoting the use of generics, devolution of budgets to practice level, incentives/disincentives for prescribers, or regulation of spending on promotion (also considered as supply‐side management) [3,4,6–9].…”

Section: Introductionmentioning

confidence: 99%

“…Pooled procurement has been implemented by various countries and organizations to improve the efficiency of purchase and distribution of pharmaceuticals; reports indicate moderate success [12–16]. The effects of pooled procurement for NZ hospitals as part of the NHPS have yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Managing Prices for Hospital Pharmaceuticals: A Successful Strategy for New Zealand?

2005

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The first year of pooled procurement under the National Hospital Pharmaceutical Strategy (2002-2003) has resulted in moderate savings. For all 29 major public hospitals, savings of around NZ dollar 5.2 million (dollar 2.9 million-dollar 8.7 million) or 3.7% were projected for 2003 to 2004. Longer-term effects, however, on patient outcomes and availability of pharmaceuticals, as well as on pharmaceutical expenditure, have yet to be evaluated.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Managing Prices for Hospital Pharmaceuticals: A Successful Strategy for New Zealand?

2005

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“…However, it can be discussed whether, or not, a policy of a 'race to the bottom' is an intended objective of EPR that is a pricing policy usually applied for new medicines. As an alternative, opportunities for savings could rather be achieved from off-patent medicines, as evidence on the price-reducing character of generic competition (40)(41)(42)(43)(44) and of tendering (45)(46)(47)(48)(49) is available.…”

Section: Discussionmentioning

confidence: 99%

Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation

Vogler

Schneider

Lepuschütz

2020

Preprint

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Background: Several governments apply the policy of external price referencing (EPR), which considers the prices of a medicine in one or more other countries for the purpose of setting the price in the own country. Different methodological choices can be taken to design the EPR policy. The study aimed to analyse whether, or not, and how changes in the methodology of EPR can impact medicine prices.Methods: The real-life EPR methodology as of Q1/2015 was surveyed in all European Union Member States, Iceland, Norway and Switzerland through a questionnaire responded by national pricing authorities. Different scenarios were developed related to the parameters of the EPR methodology. Discrete-event simulations of fictitious prices in the 28 countries of the study that had EPR in place were run for a period of 10 years. The continuation of the real-life EPR methodology in the countries as surveyed in 2015, without any change, served as base case.Results: Consideration of discounts (an assumed 20% discount in five large economies and the mandatory discount in Germany, Greece and Ireland) and determining the reference price based on the lowest price in the country basket would result in higher price reductions (on average -47.2% and -34.2% compared to the base case). An adjustment of medicine price data of the reference countries by purchasing power parities would lead to higher prices in some more affluent countries (e.g. Switzerland, Norway) and lower prices in lower-income economies (Bulgaria, Romania, Hungary, Poland). Regular price revisions and changes in the basket of reference countries would also impact medicine prices, however to a lesser extent.Conclusions: EPR has some potential for cost-containment. Medicine prices could be decreased further if certain parameters of the EPR methodology were changed. If public payers aim to apply EPR to keep medicine prices at more affordable levels, they are encouraged to explore the cost-containment potential of this policy and to take appropriate methodological choices in the design of EPR.

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“…To address the issue of access to medicines and insulin in resource-poor countries different means have been proposed or developed. One such example is bulk tendering, which can be performed by a group of countries joining together, as has been carried out in the Caribbean, or for good planning to be developed at a country level to enable large quantities of medicines to be ordered and, therefore, increase bargaining power [32]. Another recommendation has been purchasing medicines from generic producers.…”

Section: Proposed Solutionsmentioning

confidence: 99%

Improving access to insulin: what can be done?

Beran¹

2011

Diabetes Management

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Cost Containment Through Pharmaceutical Procurement: A Caribbean Case Study

Cited by 11 publications

References 0 publications

Managing Prices for Hospital Pharmaceuticals: A Successful Strategy for New Zealand?

Managing Prices for Hospital Pharmaceuticals: A Successful Strategy for New Zealand?

Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation

Improving access to insulin: what can be done?

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