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Medicines Pricing: Limitations of Existing Policies and New Models

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Global Pharmaceutical Policy

Abstract

Medicine price regulation aims to contribute to more affordable access to medicines for both patients and public payers. While there is strong evidence for its achievements, high prices remain a barrier to access, increasingly also in high-income countries. This chapter discusses existing medicine pricing policies, particularly for new medicines, such as external price referencing (EPR), value-based pricing (VBP), tendering and managed entry agreements, with a particular focus on their limitations. New models to address these drawbacks are presented; these include methodological support tools, collaborative approaches and improved transparency.

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Abbreviations

AIDS:

Acquired immune deficiency syndrome

DNDi:

Drugs for Neglected Diseases initiative

EPR:

External price referencing

EU:

European Union

EUnetHTA:

European network for health technology assessment

GAVI:

Global Alliance for Vaccines and Immunisation

GCC:

Gulf Cooperation Council

HAI:

Health Action International

HIV:

Human immunodeficiency virus

HTA:

Health technology assessment

ICER:

Incremental cost-effectiveness ratio

JPA:

Joint Procurement Agreement

LMIC:

Low- and middle-income countries

MCDA:

Multiple-criteria decision analysis

MEA:

Managed entry agreement(s)

MWPP:

Manufacturer (price), wholesale (price), pharmacy (retail price net) and pharmacy (retail price gross); alternatively manufacturer, wholesaler, pharmacy and patient

NHS:

National health service

OECS:

Pharmaceutical Procurement Service of the Organization of Eastern Caribbean States

PAHO:

Pan-American Health Organization

PPRI:

Pharmaceutical pricing and reimbursement information

R+D:

Research and development

RCT:

Randomized controlled trial(s)

RWD:

Real-world data

RWE:

Real-world evidence

SADC:

Southern African Development Community

UHC:

Universal health coverage

UN:

United Nations

UNFPA:

United Nations Population Fund

UNICEF:

United Nations International Children’s Emergency Fund

USD:

United States dollar

VBP:

Value-based pricing

WHA:

World Health Assembly

WHO:

World Health Organization

WTP:

Willingness-to-pay

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Authors and Affiliations

  1. WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich GmbH (GÖG/Austrian National Public Health Institute), Vienna, Austria

    Sabine Vogler

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  1. Sabine Vogler
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Correspondence to Sabine Vogler .

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  1. Centre for Pharmaceutical Policy and Practice Research, University of Huddersfield, Huddersfield, UK

    Zaheer-Ud-Din Babar

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Vogler, S. (2020). Medicines Pricing: Limitations of Existing Policies and New Models. In: Babar, ZUD. (eds) Global Pharmaceutical Policy. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-15-2724-1_5

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