Barriers for access to new medicines: searching for the balance between rising costs and limited budgets
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Date
2018
Authors
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Journal ISSN
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Publisher
Frontiers in public health
Abstract
Introduction: There is continued unmet medical need for new medicines across
countries especially for cancer, immunological diseases, and orphan diseases. However,
there are growing challenges with funding new medicines at ever increasing prices along
with funding increased medicine volumes with the growth in both infectious diseases
and non-communicable diseases across countries. This has resulted in the development
of new models to better manage the entry of new medicines, new financial models
being postulated to finance new medicines as well as strategies to improve prescribing
efficiency. However, more needs to be done. Consequently, the primary aim of this paper
is to consider potential ways to optimize the use of new medicines balancing rising
costs with increasing budgetary pressures to stimulate debate especially from a payer
perspective.
Methods: A narrative review of pharmaceutical policies and implications, as well
as possible developments, based on key publications and initiatives known to the
co-authors principally from a health authority perspective.
Results: A number of initiatives and approaches have been identified including new
models to better manage the entry of new medicines based on three pillars (pre-, peri-,
and post-launch activities). Within this, we see the growing role of horizon scanning
activities starting up to 36 months before launch, managed entry agreements and post
launch follow-up. It is also likely there will be greater scrutiny over the effectiveness
and value of new cancer medicines given ever increasing prices. This could include
establishing minimum effectiveness targets for premium pricing along with re-evaluating
prices as more medicines for cancer lose their patent. There will also be a greater
involvement of patients especially with orphan diseases. New initiatives could include
a greater role of multicriteria decision analysis, as well as looking at the potential for
de-linking research and development from commercial activities to enhance affordability.
Conclusion: There are a number of ongoing activities across countries to try and fund
new valued medicines whilst attaining or maintaining universal healthcare. Such activities
will grow with increasing resource pressures and continued unmet need.
Description
Keywords
Managed entry, Health policy, Pharmaceuticals
Citation
Godman, B., Bucsics, A., Vella Bonanno, P., Oortwijn, W., Rothe, C.C., Ferrario, A., Bosselli, S., Hill, A., Martin, A.P., Simoens, S. and Kurdi, A., 2018. Barriers for access to new medicines: searching for the balance between rising costs and limited budgets. Frontiers in public health, 6, p.328.