Determinants of drug prices: a systematic review of comparison studies

Daalen, Jules M. Janssen; Ambtman, Anouk Den; Houdenhoven, Mark van; Bemt, Bart J F van den

doi:10.1136/bmjopen-2020-046917

Cited by 14 publications

(9 citation statements)

References 56 publications

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“…Pertuzumab, with 8 years on the market, increased the FP by 35%, and pembrolizumab, in 4 years, had an increase of 28% over the FP. This percentage increase is even higher than in the United States, a country known for charging the highest prices for most medicines in the world ( Daalen et al, 2021 ).…”

Section: Resultsmentioning

confidence: 91%

Comparative price analysis of biological medicines: disparities generated by different pricing policies

Pontes,

Ribeiro,

Albuquerque

et al. 2024

Front. Pharmacol.

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Introduction: Biological medicines have been assuming an important role among the therapeutic options for several diseases, however, due to their complex production process, the products obtained from this technology have a high added value and do not reach the purchasing power of most patients, which overwhelms the budget of health systems. With the development of biosimilars, which have reduced production costs, it is expected that access to biological medicines will become broader. However, in Brazil, the criteria for determining the price of biosimilars, unlike the generic policy in the country, do not foresee a price reduction due to the reduction of development costs.Objective: To understand the impact of the current model of economic regulation on the availability and access of these products in the country, based on a comparative analysis in selected countries, and identify trends that can help to expand the availability and access to biological medicines.Method: Quantitative and qualitative study, to identify the variation between the entry prices of biological medicines in Brazil and in selected countries, as well as the differences in the economic regulation policies established in these countries.Results: The results demonstrate that the current pricing model in Brazil has generated distortions in the prices of biosimilars in the market, which, consequently, makes it difficult for the population to access this category of products, in addition to allowing unsustainable market practices for the systems of public and private health in Brazil. It was also found that most of the analyzed countries, unlike Brazil, seek to harmonize the prices of different brands of the same molecule marketed in the country and with the international market, in addition to establishing incentive policies for indication and replacement by biosimilars, which expands the participation of biosimilars in the market significantly.Conclusion: Based on the data presented, it is concluded that it is essential to build a broader political and regulatory debate on the market for biologicals and biosimilars in the country to guarantee the access of the Brazilian population to more cost-effective technologies, generate a more competitive market and consequently contribute to the financial sustainability of health systems.

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Section: Resultsmentioning

confidence: 91%

Comparative price analysis of biological medicines: disparities generated by different pricing policies

Pontes,

Ribeiro,

Albuquerque

et al. 2024

Front. Pharmacol.

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“…A recent literature review has shown a significant effect of the expiry date of patents, the access to the generic market, and it emphasized the importance of tendering [14]. However, this review paper also indicates that scientific knowledge on the determinants of drugs expenses is lacking, largely related to a lack of transparency on this particular market.…”

Section: Introductionmentioning

confidence: 88%

Determinants of drug expenditure in the Swiss healthcare market in 2006

Eggli

Decollogny

Piaget-Rossel

et al. 2022

BMC Health Serv Res

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Background Several measures are in force in Switzerland to control the cost of drugs, but are not effective enough. There are many determinants influencing these expenditures, related to treatments, markets, physicians, patients and regions, but their impact on costs is not clear. Methods We applied a Bayesian multilevel model with five levels to adjust for patients, drugs’ market, and physicians ‘characteristics, treatment type, and district (i.e. Swiss canton). We used data of the Swiss drugs’ market in 2006, offering real choices for doctors and patients (multiple products for similar active substances), with a neutral position of pharmacists (no financial incentives). Results Variance partitioning of yearly drugs’ cost per insured showed that market level (delivered substance) contributed to 76% of the variance, treatment level (delivered product) to 20%, whereas patients’ and physicians’ levels accounted for only 2% each, without significant differences between Swiss cantons. After adjusting for covariables at each level, the model explained about 51% of the variation at the market and 20% at the treatment levels. We found that older but substitutable drugs, generics, larger size of the market and physician’s specialty were associated with lower expenditure, whereas drugs requiring a physician’s prescription, the number of prescribers per patient, patient’ age, male gender, and comorbidities increased expenditure. Our results show that for a specific medication the yearly cost of recently released drugs was 36 CHF higher than for similar and substitutable drugs introduced 15 years earlier, corresponding to one third of the average annual treatment cost observed in our dataset. Competition did not seem to be effective to reduce expenditure on the drug market. Conclusion The main finding of this study is that recentness of drugs was associated with an increase in drug expenditure in 2006, even after adjustment for all non-controllable determinants. Further research is recommended to confirm those results with updated data.

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“…For example, the use of rebates can be implemented to adjust a drug's price according to its real-world effectiveness post approval, thus aligning the cost with the actual value delivered to patients. Another approach is tendering, which involves competitive bidding processes among pharmaceutical companies, fostering a competitive market environment that can lead to more favourable pricing outcomes for the healthcare system [ 69 ]. Once the patents for GLP-1 receptor agonists expire, it is crucial to promote and facilitate the timely development of generic alternatives or biosimilars [ 65 ].…”

Section: Increasing Societal Benefit From Incretin-based Therapymentioning

confidence: 99%

Socioeconomic aspects of incretin-based therapy

Karagiannis

Bekiari

2023

Diabetologia

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Incretin-based therapies, particularly glucagon-like peptide-1 receptor agonists (GLP-1 RAs), have demonstrated cardiovascular benefits in people with type 2 diabetes. However, socioeconomic disparities in their uptake may constrain the collective advantages offered by these medications to the broader population. In this review we examine the socioeconomic disparities in the utilisation of incretin-based therapies and discuss strategies to address these inequalities. Based on real-world evidence, the uptake of GLP-1 RAs is reduced in people who live in socioeconomically disadvantaged areas, have low income and education level, or belong to racial/ethnic minorities, even though these individuals have a greater burden of type 2 diabetes and cardiovascular disease. Contributing factors include suboptimal health insurance coverage, limited accessibility to incretin-based therapies, financial constraints, low health literacy and physician–patient barriers such as provider bias. Advocating for a reduction in the price of GLP-1 RAs is a pivotal initial step to enhance their affordability among lower socioeconomic groups and improve their value-for-money from a societal perspective. By implementing cost-effective strategies, healthcare systems can amplify the societal benefits of incretin-based therapies, alongside measures that include maximising treatment benefits in specific subpopulations while minimising harms in vulnerable individuals, increasing accessibility, enhancing health literacy and overcoming physician–patient barriers. A collaborative approach between governments, pharmaceutical companies, healthcare providers and people with diabetes is necessary for the effective implementation of these strategies to enhance the overall societal benefits of incretin-based therapies. Graphical Abstract

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Determinants of drug prices: a systematic review of comparison studies

Cited by 14 publications

References 56 publications

Comparative price analysis of biological medicines: disparities generated by different pricing policies

Comparative price analysis of biological medicines: disparities generated by different pricing policies

Determinants of drug expenditure in the Swiss healthcare market in 2006

Socioeconomic aspects of incretin-based therapy

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