Health Economic Data Requirements and Availability in the European Union: Results of a Survey Among 10 European Countries

Skoupá, Jana; Annemans, Lieven; Hájek, Petr

doi:10.1016/j.vhri.2014.06.003

Cited by 25 publications

(19 citation statements)

References 7 publications

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“…The price disparities in OECD countries may be explained partly by the pharmaceutical price-setting policies used in different countries. For example, some countries set prices according to explicit cost-effectiveness thresholds based on GDP per capita [ 49 ], average monthly wage [ 50 ], or comparative assessment [ 51 ] against interferon-based therapy. These thresholds signal the purchasers’ willingness to pay and may result in the highest possible price that satisfies the threshold, without consideration of budget impact.…”

Section: Discussionmentioning

confidence: 99%

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis

et al. 2016

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IntroductionNew hepatitis C virus (HCV) medicines have markedly improved treatment efficacy and regimen tolerability. However, their high prices have limited access, prompting wide debate about fair and affordable prices. This study systematically compared the price and affordability of sofosbuvir and ledipasvir/sofosbuvir across 30 countries to assess affordability to health systems and patients.Methods and FindingsPublished 2015 ex-factory prices for a 12-wk course of treatment were provided by the Pharma Price Information (PPI) service of the Austrian public health institute Gesundheit Österreich GmbH or were obtained from national government or drug reimbursement authorities and recent press releases, where necessary. Prices in Organisation for Economic Co-operation and Development (OECD) member countries and select low- and middle-income countries were converted to US dollars using period average exchange rates and were adjusted for purchasing power parity (PPP). We analysed prices compared to national economic performance and estimated market size and the cost of these drugs in terms of countries’ annual total pharmaceutical expenditure (TPE) and in terms of the duration of time an individual would need to work to pay for treatment out of pocket. Patient affordability was calculated using 2014 OECD average annual wages, supplemented with International Labour Organization median wage data where necessary. All data were compiled between 17 July 2015 and 25 January 2016. For the base case analysis, we assumed a 23% rebate/discount on the published price in all countries, except for countries with special pricing arrangements or generic licensing agreements.The median nominal ex-factory price of a 12-wk course of sofosbuvir across 26 OECD countries was US$42,017, ranging from US$37,729 in Japan to US$64,680 in the US. Central and Eastern European countries had higher PPP-adjusted prices than other countries: prices of sofosbuvir in Poland and Turkey (PPP$101,063 and PPP$70,331) and of ledipasvir/sofosbuvir in Poland (PPP$118,754) were at least 1.09 and 1.63 times higher, respectively than in the US (PPP$64,680 and PPP$72,765). Based on PPP-adjusted TPE and without the cost of ribavirin and other treatment costs, treating the entire HCV viraemic population with these regimens at the PPP-adjusted prices with a 23% price reduction would amount to at least one-tenth of current TPE across the countries included in this study, ranging from 10.5% of TPE in the Netherlands to 190.5% of TPE in Poland. In 12 countries, the price of a course of sofosbuvir without other costs was equivalent to 1 y or more of the average annual wage of individuals, ranging from 0.21 y in Egypt to 5.28 y in Turkey. This analysis relies on the accuracy of price information and infection prevalence estimates. It does not include the costs of diagnostic testing, supplementary treatments, treatment for patients with reinfection or cirrhosis, or associated health service costs.ConclusionsCurrent prices of these medicines are variable and unafford...

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Section: Discussionmentioning

confidence: 99%

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis

et al. 2016

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“…Resource use and unit costs were assigned to the treated cases on the using gross costing methodology, mainly due to the fact that Romanian hospitals do not record resource use and unit costs for most inputs at a patient level (16). This method assesses the costs in a "top-down" manner, meaning that the total costs of a service are divided by the number of services performed, which results in an average cost per service (17).…”

Section: Costing Methodologymentioning

confidence: 99%

Cost Assessment of Inpatient Care Episodes of Stroke in Romania

Lorenzovici

Székely²,

Csanádi³

et al. 2020

Front. Public Health

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Introduction: Stroke is the second leading cause of death worldwide and Romania is no exception. There is a high economic burden associated with the treatment of stroke patients, which puts pressure on the healthcare budget. This study aims to measure the inpatient treatment costs of stroke patients in Romania.Methods: Our retrospective analysis follows stroke patients in six Romanian hospitals at different progressivity level from different regions. Patients are identified from the official hospital databases, reported for reimbursement purposes. Mean inpatient costs incurred with the treatment of these stroke patient episodes are calculated using the gross costing method. The cost data are derived from the management control system of the study hospitals.Results: 3,155 patient episodes of stroke were identified in the study hospitals. The average cost per stroke inpatient care episode sums up to EUR 995.57 (95% CI: EUR 963.74—EUR 1 027.39) in 2017, while the overall yearly healthcare burden adds up to EUR 140 million, representing 2.18% of the total national health insurance budget and a cost of EUR 7.15 per capita.Conclusion: The hospital cost of stroke inpatient care episode in Romania is high and it represents a sizable part of the healthcare budget, but it is among the lowest in Europe, which can mainly be explained by the level of economic development of the country. As both the number of patients and the cost of acute care are expected to increase in the future, the economic burden of stroke is also expected to increase.

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“…For example, the current Romanian pharmaceutical reimbursement process relies heavily on HTA recommendations issued in Germany, France, and UK, while policymakers cannot take into account local cost-effectiveness studies. On the other hand, several CEE countries with more advanced HTA implementation mandated the use of local data in economic evaluations (Skoupá et al, 2014).…”

Section: (6) Quality and Transparency Of Hta Implementationmentioning

confidence: 99%

HTA Implementation Roadmap in Central and Eastern European Countries

Kaló

Gheorghe

Huić³

et al. 2016

Health Economics

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The opportunity cost of inappropriate health policy decisions is greater in Central and Eastern European (CEE) compared with Western European (WE) countries because of poorer population health and more limited healthcare resources. Application of health technology assessment (HTA) prior to healthcare financing decisions can improve the allocative efficiency of scarce resources. However, few CEE countries have a clear roadmap for HTA implementation. Examples from high‐income countries may not be directly relevant, as CEE countries cannot allocate so much financial and human resources for substantiating policy decisions with evidence.Our objective was to describe the main HTA implementation scenarios in CEE countries and summarize the most important questions related to capacity building, financing HTA research, process and organizational structure for HTA, standardization of HTA methodology, use of local data, scope of mandatory HTA, decision criteria, and international collaboration in HTA.Although HTA implementation strategies from the region can be relevant examples for other CEE countries with similar cultural environment and economic status, HTA roadmaps are not still fully transferable without taking into account country‐specific aspects, such as country size, gross domestic product per capita, major social values, public health priorities, and fragmentation of healthcare financing. Copyright © 2016 John Wiley & Sons, Ltd.

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Health Economic Data Requirements and Availability in the European Union: Results of a Survey Among 10 European Countries

Abstract: We found similar requirements for HE analyses in CEE and WE but differences in data availability. This results in less accurate inputs across the CEE, influencing analyses' outcomes.

Cited by 25 publications

References 7 publications

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis

Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis

Cost Assessment of Inpatient Care Episodes of Stroke in Romania

HTA Implementation Roadmap in Central and Eastern European Countries

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