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Pharmaceutical Pricing and Reimbursement News in the Second Quarter of 2008

Authors
Neil Grubert, M.A.
Spectrum -- July 2008

  Introduction:

The United States stands in stark contrast to Europe and Japan in terms of the freedom that manufacturers have to set--and increase--the prices of branded drugs in the U.S. market. However, pharmaceutical companies need to give careful thought to their pricing strategies in all markets. Payers around the world are constantly adjusting their pharmaceutical cost-containment strategies.

  Get the Answers You Need to Shape Your Strategy:

Leading pharmaceutical benefit management companies (PBMs) in the United States are seeking new ways to contain prescription drug costs. How do recent pricing trends for generics and branded drugs compare? What are PBMs doing to stimulate greater use of generics? What is the outlook for specialty pharmaceuticals?

The French government has announced a major new cost-containment initiative. How will the government’s medical control strategy be used to save €500 million ($684 million) per year? Which categories of drugs are likely to be targets for price cuts? Which drug class could be subjected to reimbursement at the price level of generics?

German health insurance funds recently cut reference prices in 59 reference pricing groups. How many products now exceed their reference prices? What impact have the reference price cuts had on the availability of copayment-exempt drugs?

The U.K. government has unveiled a new drug pricing and reimbursement system and a constitution for the National Health Service. What effect will the new Pharmaceutical Price Regulation Scheme have on U.K. drug prices? How does the government plan to stimulate pharmaceutical innovation? How is the role of the National Institute for Health and Clinical Excellence (NICE) likely to change?

  Scope:

Issues affecting the pharmaceutical industry in the United States: recent spending trends; pricing; increasing use of generics; specialty pharmacy; Medicare reforms; new active surveillance system.

Issues affecting the pharmaceutical industry in Europe: expansion of European Commission antitrust investigation; French government’s new cost-containment strategy; impact of German reference pricing cuts; Italian prescribing trends; steady growth in the Spanish prescription drug market; price cuts agreed in negotiations for new U.K. drug pricing system.

Issues affecting the pharmaceutical industry in Japan: industry association’s proposed new pricing system; unprecedented focus on expanding the generics market.

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Companies and Organizations:

  • Actelion
  • Agenzia Italiana del Farmaco (AIFA; Italian Pharmaceutical Agency)
  • Agency for Healthcare Research and Quality (AHRQ)
  • Amgen
  • Association of the British Pharmaceutical Industry (ABPI)
  • AstraZeneca
  • Bayer Vital
  • Bristol-Myers Squibb
  • Bundesverband der Betriebskrankenkassen (BKK; Federal Association of Occupational Health Insurance Funds)
  • Bundesverband der Pharmazeutischen Industrie (BPI; Federal Association of the Pharmaceutical Industry)
  • Caisse Nationale de l’Assurance Maladie (CNAM; National Health Insurance Fund), France
  • Caisse Nationale de l’Assurance Maladie des Travailleurs Salariés (CNAM; National Health Insurance Fund for Salaried Workers), France
  • Centers for Medicare and Medicaid Services (CMS)
  • Comité Economique des Produits de Santé (CEPS; Economic Committee for Healthcare Products), France
  • Confederation of British Industry (CBI), United Kingdom
  • CVS Caremark
  • Department of Defense (DoD)
  • Department of Health and Human Services (HHS)
  • Department of Veterans Affairs (VA)
  • Eisai
  • Encysive
  • European Commission
  • European Court of Justice
  • European Union (EU)
  • Express Scripts
  • FDA
  • Federación Empresarial de Farmacéuticos Españoles (FEFE; Business Federation of Spanish Pharmacists), Spain
  • Federal Trade Commission
  • Gemeinsamer Bundesausschuß der Ärzte, Zahnärzte, Krankenhäuser und Krankenkassen (GBA; Joint Federal Committee of Physicians, Dentists, Hospitals, and Health Insurance Funds), Germany
  • Gesetzliche Krankenversicherung (GKV; statutory health insurance) system, Germany
  • Institute of Medicine
  • Japan Generic Pharmaceutical Manufacturers Association (JGPMA)
  • Japan Pharmaceutical Manufacturers Association (JPMA)
  • Lundbeck
  • Medco
  • Merck
  • Merck-Serono
  • Ministry of Health, Labor, and Welfare (MHLW), Japan
  • Mission d’Evaluation et de Contrôle des Lois de Financement de la Sécurité Sociale (MECSS; Commission for the Evaluation and Monitoring of Social Security Finance Laws), France
  • National Drug Center
  • National Health Service (NHS), United Kingdom
  • National Institute for Health and Clinical Excellence (NICE), United Kingdom
  • Nippon Pharmacy Association (NPhA), Japan
  • Office of Fair Trading (OFT), United Kingdom
  • Osservatorio Nazionale sull’Impiego dei Medicinali (OsMed; National Observatory on the Use of Medicines), Italy
  • Pharmaceutical Research and Manufacturers of America (PhRMA)
  • Pfizer
  • Roche
  • Sanofi-Aventis
  • Servizio Sanitario Nazionale (SSN; National Health Service), Italy
  • Shire Pharmaceuticals
  • Sistema Nacional de Salud (SNS; National Health System), Spain
  • Spitzenverbände der Krankenkassen (leading associations of health insurance funds), Germany
  • Union Nationale des Caisses d’Assurance-Maladie (UNCAM; National Union of Health Insurance Funds), France
  • U.S. House of Representatives
  • U.S. Senate
  • Wettbewerbskommission (Competition Commission), Switzerland



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