Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review.
Identifieur interne : 000542 ( PubMed/Checkpoint ); précédent : 000541; suivant : 000543Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review.
Auteurs : Bonny Parkinson [Australie] ; Catherine Sermet ; Fiona Clement ; Steffan Crausaz ; Brian Godman ; Sarah Garner ; Moni Choudhury ; Sallie-Anne Pearson ; Rosalie Viney ; Ruth Lopert ; Adam G. ElshaugSource :
- PharmacoEconomics [ 1179-2027 ] ; 2015.
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Abstract
Pharmaceutical expenditure has increased rapidly across many Organisation for Economic Cooperation and Development (OECD) countries over the past three decades. This growth is an increasing concern for governments and other third-party payers seeking to provide equitable and comprehensive healthcare within sustainable budgets. In order to create headroom for increasing utilisation, and to fund new high-cost therapies, there is an active push to 'disinvest' from low-value drugs. The aim of this article is to review how reimbursement policy decision makers have sought to partially or completely disinvest from drugs in a range of OECD countries (UK, France, Canada, Australia and New Zealand) where they are publicly funded or subsidised. We employed a systematic literature search strategy and the incorporation of grey literature known to the authorship team. We canvass key policy instruments from each country to outline key approaches to the identification of candidate drugs for disinvestment assessment (passive approaches vs. more active approaches); methods of disinvestment and value-based purchasing (de-listing, restricting treatment, price or reimbursement rate reductions, encouraging generic prescribing); lessons learnt from the various approaches; the potential role of coverage with evidence development; and the need for careful stakeholder management. Dedicated sections are provided with detailed coverage of policy approaches (with drug examples) from each country. Historically, countries have relied on 'passive disinvestment'; however, due to (1) the availability of new cost-effectiveness evidence, or (2) 'leakage' in drug utilisation, or (3) market failure in terms of price competition, there is an increasing focus towards 'active disinvestment'. Isolating low-value drugs that would create headroom for innovative new products to enter the market is also motivating disinvestment efforts by multiple parties, including industry. Historically, disinvestment has mainly taken the form of price reductions, especially when market failures are perceived to exist, and restricting treatment to subpopulations, particularly when a drug is no longer considered value for money. There is considerable experimentation internationally in mechanisms for disinvestment and the opportunity for countries to learn from each other. Ongoing evaluation of disinvestment strategies is essential, and ought to be reported in the peer-reviewed literature.
DOI: 10.1007/s40273-015-0293-8
PubMed: 26048353
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Elshaug</name></author></analytic><series><title level="j">PharmacoEconomics</title><idno type="eISSN">1179-2027</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Decision Making</term><term>Drug Costs</term><term>Drug Utilization (economics)</term><term>Health Policy</term><term>Humans</term><term>Insurance, Health, Reimbursement (economics)</term><term>Organisation for Economic Co-Operation and Development</term><term>Value-Based Purchasing (economics)</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Drug Utilization</term><term>Insurance, Health, Reimbursement</term><term>Value-Based Purchasing</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Decision Making</term><term>Drug Costs</term><term>Health Policy</term><term>Humans</term><term>Organisation for Economic Co-Operation and Development</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Pharmaceutical expenditure has increased rapidly across many Organisation for Economic Cooperation and Development (OECD) countries over the past three decades. This growth is an increasing concern for governments and other third-party payers seeking to provide equitable and comprehensive healthcare within sustainable budgets. In order to create headroom for increasing utilisation, and to fund new high-cost therapies, there is an active push to 'disinvest' from low-value drugs. The aim of this article is to review how reimbursement policy decision makers have sought to partially or completely disinvest from drugs in a range of OECD countries (UK, France, Canada, Australia and New Zealand) where they are publicly funded or subsidised. We employed a systematic literature search strategy and the incorporation of grey literature known to the authorship team. We canvass key policy instruments from each country to outline key approaches to the identification of candidate drugs for disinvestment assessment (passive approaches vs. more active approaches); methods of disinvestment and value-based purchasing (de-listing, restricting treatment, price or reimbursement rate reductions, encouraging generic prescribing); lessons learnt from the various approaches; the potential role of coverage with evidence development; and the need for careful stakeholder management. Dedicated sections are provided with detailed coverage of policy approaches (with drug examples) from each country. Historically, countries have relied on 'passive disinvestment'; however, due to (1) the availability of new cost-effectiveness evidence, or (2) 'leakage' in drug utilisation, or (3) market failure in terms of price competition, there is an increasing focus towards 'active disinvestment'. Isolating low-value drugs that would create headroom for innovative new products to enter the market is also motivating disinvestment efforts by multiple parties, including industry. Historically, disinvestment has mainly taken the form of price reductions, especially when market failures are perceived to exist, and restricting treatment to subpopulations, particularly when a drug is no longer considered value for money. There is considerable experimentation internationally in mechanisms for disinvestment and the opportunity for countries to learn from each other. Ongoing evaluation of disinvestment strategies is essential, and ought to be reported in the peer-reviewed literature.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26048353</PMID><DateCreated><Year>2015</Year><Month>09</Month><Day>04</Day></DateCreated><DateCompleted><Year>2016</Year><Month>12</Month><Day>13</Day></DateCompleted><DateRevised><Year>2016</Year><Month>12</Month><Day>30</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1179-2027</ISSN><JournalIssue CitedMedium="Internet"><Volume>33</Volume><Issue>9</Issue><PubDate><Year>2015</Year><Month>Sep</Month></PubDate></JournalIssue><Title>PharmacoEconomics</Title><ISOAbbreviation>Pharmacoeconomics</ISOAbbreviation></Journal><ArticleTitle>Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review.</ArticleTitle><Pagination><MedlinePgn>905-24</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s40273-015-0293-8</ELocationID><Abstract><AbstractText>Pharmaceutical expenditure has increased rapidly across many Organisation for Economic Cooperation and Development (OECD) countries over the past three decades. This growth is an increasing concern for governments and other third-party payers seeking to provide equitable and comprehensive healthcare within sustainable budgets. In order to create headroom for increasing utilisation, and to fund new high-cost therapies, there is an active push to 'disinvest' from low-value drugs. The aim of this article is to review how reimbursement policy decision makers have sought to partially or completely disinvest from drugs in a range of OECD countries (UK, France, Canada, Australia and New Zealand) where they are publicly funded or subsidised. We employed a systematic literature search strategy and the incorporation of grey literature known to the authorship team. We canvass key policy instruments from each country to outline key approaches to the identification of candidate drugs for disinvestment assessment (passive approaches vs. more active approaches); methods of disinvestment and value-based purchasing (de-listing, restricting treatment, price or reimbursement rate reductions, encouraging generic prescribing); lessons learnt from the various approaches; the potential role of coverage with evidence development; and the need for careful stakeholder management. Dedicated sections are provided with detailed coverage of policy approaches (with drug examples) from each country. Historically, countries have relied on 'passive disinvestment'; however, due to (1) the availability of new cost-effectiveness evidence, or (2) 'leakage' in drug utilisation, or (3) market failure in terms of price competition, there is an increasing focus towards 'active disinvestment'. Isolating low-value drugs that would create headroom for innovative new products to enter the market is also motivating disinvestment efforts by multiple parties, including industry. Historically, disinvestment has mainly taken the form of price reductions, especially when market failures are perceived to exist, and restricting treatment to subpopulations, particularly when a drug is no longer considered value for money. There is considerable experimentation internationally in mechanisms for disinvestment and the opportunity for countries to learn from each other. Ongoing evaluation of disinvestment strategies is essential, and ought to be reported in the peer-reviewed literature.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Parkinson</LastName><ForeName>Bonny</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia, bonny.parkinson@chere.uts.edu.au.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sermet</LastName><ForeName>Catherine</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Clement</LastName><ForeName>Fiona</ForeName><Initials>F</Initials></Author><Author ValidYN="Y"><LastName>Crausaz</LastName><ForeName>Steffan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Godman</LastName><ForeName>Brian</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Garner</LastName><ForeName>Sarah</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Choudhury</LastName><ForeName>Moni</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Pearson</LastName><ForeName>Sallie-Anne</ForeName><Initials>SA</Initials></Author><Author ValidYN="Y"><LastName>Viney</LastName><ForeName>Rosalie</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Lopert</LastName><ForeName>Ruth</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Elshaug</LastName><ForeName>Adam G</ForeName><Initials>AG</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>New Zealand</Country><MedlineTA>Pharmacoeconomics</MedlineTA><NlmUniqueID>9212404</NlmUniqueID><ISSNLinking>1170-7690</ISSNLinking></MedlineJournalInfo><CitationSubset>T</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Pharmacoeconomics. 2016 Apr;34(4):421-2</RefSource><PMID Version="1">26924302</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Pharmacoeconomics. 2016 Apr;34(4):419-20</RefSource><PMID Version="1">26924301</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D003657" MajorTopicYN="N">Decision Making</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016527" MajorTopicYN="Y">Drug Costs</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004363" MajorTopicYN="N">Drug Utilization</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006291" MajorTopicYN="N">Health Policy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007349" MajorTopicYN="N">Insurance, Health, Reimbursement</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D066150" MajorTopicYN="N">Organisation for Economic Co-Operation and Development</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D062505" MajorTopicYN="N">Value-Based Purchasing</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>6</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>6</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26048353</ArticleId><ArticleId IdType="doi">10.1007/s40273-015-0293-8</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Australie</li></country></list><tree><noCountry><name sortKey="Choudhury, Moni" sort="Choudhury, Moni" uniqKey="Choudhury M" first="Moni" last="Choudhury">Moni Choudhury</name><name sortKey="Clement, Fiona" sort="Clement, Fiona" uniqKey="Clement F" first="Fiona" last="Clement">Fiona Clement</name><name sortKey="Crausaz, Steffan" sort="Crausaz, Steffan" uniqKey="Crausaz S" first="Steffan" last="Crausaz">Steffan Crausaz</name><name sortKey="Elshaug, Adam G" sort="Elshaug, Adam G" uniqKey="Elshaug A" first="Adam G" last="Elshaug">Adam G. Elshaug</name><name sortKey="Garner, Sarah" sort="Garner, Sarah" uniqKey="Garner S" first="Sarah" last="Garner">Sarah Garner</name><name sortKey="Godman, Brian" sort="Godman, Brian" uniqKey="Godman B" first="Brian" last="Godman">Brian Godman</name><name sortKey="Lopert, Ruth" sort="Lopert, Ruth" uniqKey="Lopert R" first="Ruth" last="Lopert">Ruth Lopert</name><name sortKey="Pearson, Sallie Anne" sort="Pearson, Sallie Anne" uniqKey="Pearson S" first="Sallie-Anne" last="Pearson">Sallie-Anne Pearson</name><name sortKey="Sermet, Catherine" sort="Sermet, Catherine" uniqKey="Sermet C" first="Catherine" last="Sermet">Catherine Sermet</name><name sortKey="Viney, Rosalie" sort="Viney, Rosalie" uniqKey="Viney R" first="Rosalie" last="Viney">Rosalie Viney</name></noCountry><country name="Australie"><noRegion><name sortKey="Parkinson, Bonny" sort="Parkinson, Bonny" uniqKey="Parkinson B" first="Bonny" last="Parkinson">Bonny Parkinson</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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