OBJECTIVES: Several studies forecasting health care spending predict continuously increasing expenses due to at least three different factors; ageing, technical progress, and increasing prices. The aim of this study is to identify the effects of influencing factors on the German oncology related expenditures on prescribed drugs (OREPD) considering predictor variables such as elderly (65 years and older) population (POP65), two pharmaceutical innovation proxies (product age [LC] and novelty [NEW]), parallel trade (PI), logarithmized prices (PRICE), and relevant health care reforms (REFORM) of oncology related ATC classes (ATC). METHODS: A Random Coefficient Mixed Model is implemented to explore multivariate longitudinal/repeated observation data excluding between-drug variation from error, providing more efficient estimators by separating aging (changes over time within drugs) from cohort (differences between drugs at baseline) effects. RESULTS: The analyses including logarithmized German monthly prescription data for a 5 years period (2003-2007) covering all relevant ATC classes related to cancer treatment show highly significant effects within a fixed effects model for LC(0.0043,p < 0.0001), NEW(-1.6264,p < 0.0001), PI(2.1314,p < 0.0001), and POP65(-2.19E-7,p < 0.0001). The random effect model also provides highly significant results for the drug specific INTERCEPT (37.0127,p < 0.0001), time-variant effects of REFORM(0.0005,p < 0.0001), and PRICE(1.3300,p0.0001). CONCLUSIONS: The results show increasing oncology related prescriptions with increasing manufactures (respectively decreasing parallel importers) in the market and the longer the drugs are available in the market. It seems that prescriptions are influenced by a certain awareness and trust in new drugs. The newer the drug the less it's prescribed which might be a consequence of risk adversity due to lacking experienced successful treatments. Decreasing prescriptions with increasing elderly population is somewhat counterintuitive but might be caused by multimorbidity and difficulties due to adverse effects of multiple prescriptions. The intercept indicates a high baseline and over time reforms are not successful in cost containment. Additionally, increasing prices lead to increasing oncology related prescriptions.
Ilgin, Y. (2009). PCN156 EFFECTS OF PHARMACEUTICAL INNOVATION AND DEMOGRAPHIC CHANGE ON THE GERMAN ONCOLOGY MARKET. Value in Health, 12(7), A287. https://doi.org/10.1016/s1098-3015(10)74406-5