Forecasting Pharmaceutical Prices for Economic Evaluations When There Is No Market: A Review

Abstract

BackgroundEconomic evaluation helps policy makers and healthcare payers make decisions on drug listing, coverage, and reimbursement. When economic evaluations are conducted before a product launch, the prices of the pharmaceuticals have to be forecast.ObjectiveThe aim of this study was to examine the methods of establishing proxy prices and their accuracies compared with actual market prices after the product launch.MethodsWe searched the literature for evaluations for drugs that were licensed in the US between 2010 and 2015. We reviewed the studies for the forecasting strategies used, and then estimated the difference between actual 2016 post-launch prices and what the proxy prices would be if the forecast was carried out in the US in 2016.ResultsWe identified six such studies, with seven drugs. Four studies used substitute drugs as proxies for the study drug, and three used other methods. The range of the values of actual minus proxy price varied considerably, and no trend was observed.ConclusionForecasting drug prices is as precarious as forecasting in other areas of the economy. We urge caution in reviewing and accepting a cost-effectiveness ratio that is based on forecast prices.

Comment on: “Forecasting Pharmaceutical Prices for Economic Evaluations When There is No Market: A Review”

“…the average absolute value of the ( A  −  E )/ E index for a method based on a close substitute and others equalled—after correction—84 and 45%, respectively. Those values in the study of Akpinar et al [1] were 68 and 80%, respectively, indicating slightly better performance of the method using the price of a close substitute. That conclusion no longer holds true after the adjustment.…”

“…In their publication in Pharmacoeconomics Open , Akpinar et al [1] reported the results of their review of methods for forecasting drug prices for economic evaluations. This was an interesting article, and I agreed with most of the conclusions.…”

“…Akpinar et al [1] obtained the actual (post-launch) prices from official sources in the USA or Canada. However, some of the economic analyses were conducted for different markets.…”

“…The mechanisms for controlling prices differ between markets, and neglecting to account for these differences may introduce bias. Hence, the forecasting efficiency ([ A  −  E ]/ E index proposed by Akpinar et al [1], where A is the actual and E is the expected or forecast price of a drug) should be calculated using current prices in the same market for economic evaluation. The updated information for economic evaluations conducted outside of the USA and Canada [2, 3] are presented in Table 1.…”

The Economic Contribution of Industry-Sponsored Pharmaceutical Clinical Trials

“…We then developed a hierarchical method to identify the unit price of each drug used in study trials (9). Firstly, we used the Alberta Health Drug Benefit List (ADBL) (10) to provide a market dollar value for a unit of the drug in the trial (32 drugs).…”