Interface management of pharmacotherapy. Joint hospital and primary care drug recommendations

Björkhem‐Bergman, Linda; Andersén-Karlsson, Eva; Laing, Richard; Diogène, Eduard; Melien, Øyvind; Jirlow, Malena; Malmström, Rickard E.; Vogler, Sabine; Godman, Brian; Gustafsson, Lars L.

doi:10.1007/s00228-013-1497-5

Cited by 80 publications

(135 citation statements)

References 14 publications

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“…Increased adherence also reduces costs (21,24,66). There are similar examples in Spain and Scotland (12,60,65).…”

Section: Discussionmentioning

confidence: 96%

“…We believe these can be achieved through active formulary management and an increase in continuous physician medical education. This includes benchmarking physician prescribing habits similar to what has been achieved by initiatives in Scotland, Spain and Sweden (60,65). However, as discussed, for long term, sustained rational use of medicines in China, there must be changes in the remuneration system for hospitals and physicians to reduce their reliance on the profitability from drug procurement for their continued sustainability.…”

Section: Discussionmentioning

confidence: 98%

“…This could potentially reduce adverse drug reactions and drug: drug interactions as well as strengthen the procurement process. This was the philosophy behind the generation of the Wise List in the Stockholm Healthcare Region, Sweden, which contains approximately 200 drugs including first and second line choices covering most of the needs in ambulatory care (21,24,65). An additional 100 drugs are included in a separate list reserved for common needs in specialist in-and out-patient care.…”

Section: Discussionmentioning

confidence: 99%

“…An additional 100 drugs are included in a separate list reserved for common needs in specialist in-and out-patient care. High adherence rates at 80 to 90%% to the voluntary Wise List are enhanced by the involvement of prescribers in the selection process, a comprehensive communication program including a separate list for both patients and physicians, physician trust in the guidance, as well as regular feedback (24,65). Increased adherence also reduces costs (21,24,66).…”

Section: Discussionmentioning

confidence: 99%

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Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

Zhang

Godman

et al. 2014

GaBI J

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Introduction: Pharmaceutical expenditure rose by 16% per annum in China during the past decade, and now represents 46% of total health care expenditure. Initiatives to moderate growth include pricing regulations for pharmaceuticals and encouraging INN prescribing. However, there is limited monitoring of physician prescribing and current incentives encourage hospitals and physicians to profit from drug procurement. Objective: Assess changes in statin utilisation and expenditure as additional generics are launched. Subsequently, compare results in China with findings among European countries to provide future guidance. Methods: Observational retrospective study of statin utilisation and procurement expenditure from 2004 to 2013 in two large teaching hospital groups. Results: Statin utilisation rose 32 fold in one hospital group and 54 fold in the other. Expenditure also increased but to a lesser extent, i.e. from just over CNY 0.65 million in 2004 to 15.3 million in 2013 in one hospital group and from CNY 0.49 to 19.3 million in the other. Atorvastatin (originator) was the most utilised statin. Utilisation of each generic statin was typically low, e.g. 10% in 2013 in one hospital group. Procurement prices fell over time, greatest for generic simvastatin (-74 to -91%) mirroring data from European countries. However, no increase in their prescribing was observed. In fact, a significant decrease in generic prescribing was seen in one hospital group between 2004 and 2013. Conclusion: There are considerable opportunities to improve prescribing efficiency in China based on European experience. However, current incentives encouraging hospitals and physicians to profit from drug procurement need to be addressed.

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“…Increased adherence also reduces costs (21,24,66). There are similar examples in Spain and Scotland (12,60,65).…”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

Zhang

Godman

et al. 2014

GaBI J

Self Cite

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“…This setup incentivized payers to shift patients, treatments and thus costs between sectors. The transfer could have negative clinical outcomes, and in turn may even increase overall healthcare costs [152]. In the Netherlands, defined high-priced medicines used in hospitals are funded by the health insurers (instead out of the hospital budget).…”

Section: New Funding Modelsmentioning

confidence: 99%

How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries

Vogler

Paris

Ferrario

et al. 2017

Appl Health Econ Health Policy

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151

118

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Key points for Decision Makers: European countries apply different pharmaceutical pricing and reimbursement policies. These policies are frequently assessed against their financial consequences and their ability to contain costs but less so in terms of access to medicines. Policies should be accompanied by regular evaluations, facilitated by the use of the appropriate methodology and access to the relevant data. There appears to be a need for additional changes beyond traditional pharmaceutical pricing and reimbursement policies. Collaborative approaches (e.g. between countries or between regulatory authorities, pricing and reimbursement agencies) and more transparency in terms of real medicine prices, R+D costs and medicines in the pipeline are considered as possible pathways for the future. AbstractThe paper discusses pharmaceutical pricing and reimbursement policies in European countries with regard to their ability to ensure affordable access to medicines. A frequently applied pricing policy is external price referencing. While it provides some benchmark for policy-makers and has shown to be able to generate savings, it may also contribute to delay in product launch in countries where medicine prices are low. Value-based pricing has been proposed as a policy that promotes access while rewarding useful innovation, however implementing it has proven quite challenging. For high-priced medicines, managed-entry agreements are increasingly used. These agreements allow policy-makers to manage uncertainty and obtain lower prices. They can also facilitate earlier market access in case of limited evidence about added therapeutic value of the medicine. However, these agreements raise transparency concerns due to the confidentiality clause. Tendering as used in the 2 hospital and offpatent outpatient sectors has proven to reduce medicine prices but it requires a robust framework and appropriate design with clear strategic goals in order to prevent shortages. These pricing and reimbursement policies are supplemented by the widespread use of Health Technology Assessment to inform decision-making, and by strategies to improve the uptake of generics, and also biosimilars. While European countries have been implementing a set of policy options, there is a lack of thorough impact assessments of several pricing and reimbursement policies on affordable access. Increased cooperation between authorities, experience sharing, and improving transparency on price information, including the disclosure of confidential discounts, are opportunities to address current challenges.3

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Pharmaceutical Pricing in Europe

Vogler

Martikainen

2014

Pharmaceutical Prices in the 21st Century

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Interface management of pharmacotherapy. Joint hospital and primary care drug recommendations

Abstract: The successful models in Scotland and in Stockholm as well as the ongoing work in Catalonia were considered as examples of multifaceted approaches to improve the quality of medicine use across primary and hospital care.

Cited by 80 publications

References 14 publications

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries

Pharmaceutical Pricing in Europe

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