PHP103 Global Health Care Reforms and Pricing, Access and Health Outcomes Strategy

  • Aggarwal S
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Abstract

OBJECTIVES: During 2009-2011 major healthcare reforms were proposed and im- plemented in a number of nations, for example, Affordable Care Act in the US, AMNOG in Germany, HSPT in France, KVG in Switzerland and NHS proposed re- form in the UK. These reforms have major implications on pricing, market access and HEOR strategy for drug and device products. METHODS: To understand the implications of these trends, we analyzed 2009-2011 reform bills and proposed changes worldwide. Additionally, we interviewed public and private payers, key opinion leaders and payer-influencers to understand implications of these reforms on drug and device manufacturers. Stakeholders ranked various data collection methods on a scale of 1-10 (1-least important and 10-most important). RESULTS: The global healthcare landscape is expected to undergo significant change during 2012-2016. In the US, government will play increased role as a single payer, espe- cially with-Medicare, Medicaid and CHIP programs- which will cover 114 million Americans, at a cost of $ 784 billion.In Germany, AMNOG bill marked the end of free drug pricing and would lead to increased insurance premiums (now 15.5% of wages). In the UK, NHS has proposed to replace PCTs with 500-1000 GP-led consor- tia and use value-based pricing for expensive drugs and devices. Randomized con- trolled trial, budget impact model and systematic reviews-ranked highest (7.5- 9.1) among payers. Overall, payers view that in the future, health economic assessments would play critical role in pricing, coverage and reimbursement of branded products. CONCLUSIONS: This analysis shows that global healthcare landscape is expected to undergo significant change during 2012-2016. Discussions with payers, KOLs and payer-influencers highlights increased importance of HEOR data in the future.

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Aggarwal, S. (2011). PHP103 Global Health Care Reforms and Pricing, Access and Health Outcomes Strategy. Value in Health, 14(7), A351–A352. https://doi.org/10.1016/j.jval.2011.08.654

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