Relationship between financial impact and coverage of drugs in Australia

Abstract

Objectives: The aim of this study was to estimate the relationship between the financial impact of a new drug and the recommendation for reimbursement by the Australian Pharmaceutical Benefits Advisory Committee (PBAC). Methods: Data in the PBAC summary database were abstracted for decisions made between July 2005 and November 2009. Financial impact - the upper bound of the values presented in the PBAC summary database - was categorized as ≤A0, >A0 up to A10 million, A10 million up to A30 million, and >A30 million per year. Descriptive, logistic, survival, and recursive partitioning decision analyses were used to estimate the relationship between the financial impact of a new drug indication and the recommendation for reimbursement. Multivariable analyses controlled for other clinical and economic variables, including cost per quality-adjusted life-year gained. Results: Financial impact was a significant predictor of the recommendation for reimbursement. In the logistic analysis, the odds ratios of reimbursement for drug submissions with financial impacts ≥A10 million to ≥A30 million or >A0 to