International Price Comparisons of Anticancer Drugs: A Scheme for Improving Patient Accessibility

Abstract

Background: The demand for implementing a new listing scheme to expedite patient access to novel oncology drugs has increased in South Korea. This study was conducted to compare the prices of anticancer drugs between eight countries and to explore the feasibility of a ‘pre-listing and post-evaluation’ scheme to expedite patient access to oncology drugs. Methods: This study included 34 anticancer drugs, which were reimbursed between 1 January 2007 and 31 December 2017. The unit price and sales volume of the study drugs were collected from eight countries and IQVIA data, respectively. The prices were adjusted to estimate the ex-factory prices using the discount/rebate rate suggested by the Health Insurance Review Agency (HIRA). The four price indices of Laspeyres, Paasche, Fisher, and the unweighted index were calculated using the price in each country, the average price, and lowest price among the study countries. Each currency was converted using the currency exchange rate and purchasing power parity (PPP). The budget impact of implementing the proposed pre-listing and post-evaluation scheme on payers was calculated. Results: Based on the currency exchange rate, anticancer drug prices were higher in other countries (index range: 1.05–2.78) compared to Korea. The prices in Korea were similar to countries with the lowest prices. When the PPP was applied, prices were higher in the US, Germany, Italy, and Japan than in Korea (range: 1.10–2.13); however, the prices were lower in the UK, France, and Switzerland than in Korea (range: 0.72–0.99). The financial burden of implementing the pre-listing and post-evaluation scheme was calculated at 0.83% of the total anticancer drug sales value in Korea from 2013–2017. Conclusions: The prices of anticancer drugs in Korea were similar to the lowest prices among the seven other study countries. A pre-listing and post-evaluation scheme should be considered to improve patient access to novel anticancer drugs by reducing the reimbursement review time and uncertainties.

Variables affecting new drug prices in South Korea’s pricing system

“…Furthermore, various studies on topics related to drug pricing, including analyses of determinants affecting drug prices and comparisons of ex-factory prices per unit, have been conducted in Japan, Australia, and the United Kingdom ( Jørgensen and Kefalas, 2016 ; Vogler et al, 2016 ; Young et al, 2017 ; Trotta et al, 2019 ; Gandjour et al, 2020 ; Mamiya and Igarashi, 2021 ; Kawakami and Masamune, 2022 ). One study compared the prices of oncology drugs in South Korea, listed from 2007 to 2017, with those in A7 countries, to assess patient accessibility to novel oncology drugs ( Jung et al, 2021 ). Although numerous studies have explored the variables affecting the price of new drugs, empirical research on what factors influence the decision-making involved in setting new drug prices in South Korea has not yet been conducted.…”