IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v124y2020i12p1297-1309.html
   My bibliography  Save this article

Pricing of in-patent pharmaceuticals in the Middle East and North Africa: Is external reference pricing implemented optimally?

Author

Listed:
  • Kanavos, Panos
  • Kamphuis, Bregtje W.
  • Fontrier, Anna-Maria
  • Colville Parkin, Georgia
  • Saleh, Shadi
  • Akhras, Kasem S.

Abstract

In this paper we outline and compare pharmaceutical pricing policies for in-patent prescription pharmaceuticals with emphasis on external reference pricing (ERP) in eleven countries across the Middle East and North Africa (MENA) region and explore possible improvements in their pricing systems. Primary and secondary evidence was used to inform our analysis. Comparative analysis of ERP systems across countries followed an analytical framework distilling ERP into twelve salient features, while ERP system performance was benchmarked against a framework of best practice principles across (a) objectives and scope, (b) administration and operations, (c) methods used, and (d) implementation. Results suggest that ERP is the dominant pricing method for in-patent pharmaceuticals. Although several good practice cases were identified, none of the eleven countries satisfy all best practice principles. ERP basket sizes vary significantly and are commonly composed using geographical proximity and low-price countries as criteria. Nine countries do not use the mean or median prices, but resort to using the lowest. Exchange rate fluctuations are routinely used to arrive at price reductions in local currency. Significant opportunities exist for MENA countries to develop their ERP regimes to achieve greater compliance with best practice principles. Over the short-term, incremental changes could be implemented to several ERP salient features and can be achieved relatively easily, thereby enhancing the functionality and performance of national ERP systems. Countries in the region can also focus on the development of explicit value assessment systems, and minimize their dependence on ERP over the longer-term.

Suggested Citation

  • Kanavos, Panos & Kamphuis, Bregtje W. & Fontrier, Anna-Maria & Colville Parkin, Georgia & Saleh, Shadi & Akhras, Kasem S., 2020. "Pricing of in-patent pharmaceuticals in the Middle East and North Africa: Is external reference pricing implemented optimally?," Health Policy, Elsevier, vol. 124(12), pages 1297-1309.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:12:p:1297-1309
    DOI: 10.1016/j.healthpol.2020.07.017
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851020301998
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2020.07.017?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Jennifer Gill & Anna-Maria Fontrier & Dionysis Kyriopoulos & Panos Kanavos, 2019. "Variations in external reference pricing implementation: does it matter for public policy?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1375-1397, December.
    2. Gill, Jennifer & Fontrier, Anna-Maria & Kyriopoulos, Dionysis & Kanavos, Panos, 2019. "Variations in external reference pricing implementation: does it matter for public policy?," LSE Research Online Documents on Economics 101586, London School of Economics and Political Science, LSE Library.
    3. Panos Kanavos & Anna-Maria Fontrier & Jennifer Gill & Olina Efthymiadou, 2020. "Does external reference pricing deliver what it promises? Evidence on its impact at national level," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 129-151, February.
    4. Fontrier, Anna-Maria & Gill, Jennifer & Kanavos, Panos, 2019. "International impact of external reference pricing: should national policy makers care?," LSE Research Online Documents on Economics 100929, London School of Economics and Political Science, LSE Library.
    5. Håkonsen, Helle & Horn, Anne Marie & Toverud, Else-Lydia, 2009. "Price control as a strategy for pharmaceutical cost containment--What has been achieved in Norway in the period 1994-2004?," Health Policy, Elsevier, vol. 90(2-3), pages 277-285, May.
    6. Anna-Maria Fontrier & Jennifer Gill & Panos Kanavos, 2019. "International impact of external reference pricing: should national policy-makers care?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1147-1164, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kanavos, Panos, 2019. "Does external reference pricing deliver what it promises? Evidence on its impact at national level," LSE Research Online Documents on Economics 101522, London School of Economics and Political Science, LSE Library.
    2. Panos Kanavos & Anna-Maria Fontrier & Jennifer Gill & Olina Efthymiadou, 2020. "Does external reference pricing deliver what it promises? Evidence on its impact at national level," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(1), pages 129-151, February.
    3. Anna-Maria Fontrier & Jennifer Gill & Panos Kanavos, 2019. "International impact of external reference pricing: should national policy-makers care?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1147-1164, November.
    4. Jennifer Gill & Anna-Maria Fontrier & Dionysis Kyriopoulos & Panos Kanavos, 2019. "Variations in external reference pricing implementation: does it matter for public policy?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(9), pages 1375-1397, December.
    5. Fontrier, Anna-Maria & Gill, Jennifer & Kanavos, Panos, 2019. "International impact of external reference pricing: should national policy makers care?," LSE Research Online Documents on Economics 100929, London School of Economics and Political Science, LSE Library.
    6. Hu, Bill & Hwang, Joon Ho & Jiang, Christine & Washam, Jim & Zeng, Li, 2022. "Down to the cents: The case of international drug prices," Finance Research Letters, Elsevier, vol. 46(PA).
    7. Gamba, S.; & Pertile, P.; & Righetti, G.;, 2022. "Spillovers of Pharmaceutical Price Regulations: evidence from the AMNOG Reform in Germany," Health, Econometrics and Data Group (HEDG) Working Papers 22/20, HEDG, c/o Department of Economics, University of York.
    8. Cremer, Helmuth & Lozachmeur, Jean-Marie, 2022. "Coinsurance vs. co-payments: Reimbursement rules for a monopolistic medical product with competitive health insurers," Journal of Health Economics, Elsevier, vol. 84(C).
    9. Yu, Xuan & Li, Cheng & Shi, Yuhua & Yu, Min, 2010. "Pharmaceutical supply chain in China: Current issues and implications for health system reform," Health Policy, Elsevier, vol. 97(1), pages 8-15, September.
    10. Mondelo-García, Cristina & Mendoza, Elvia & Movilla-Fernández, María-Jesús & Coronado, Carmen, 2018. "Perceptions of pharmacists and physicians on generic substitution in a financial crisis context in Northwestern Spain: A qualitative study," Health Policy, Elsevier, vol. 122(12), pages 1316-1325.
    11. Kwon, Hye-Young & Hong, Ji-Min & Godman, Brian & Yang, Bong-Min, 2013. "Price cuts and drug spending in South Korea: The case of antihyperlipidemic agents," Health Policy, Elsevier, vol. 112(3), pages 217-226.
    12. Kwon, Hye-Young & Bae, Seungjin & Choi, Sang-eun & Park, Sylvia & Lee, Eui-Kyung & Park, Sungmin & Kim, Jinhyun, 2019. "Easy cuts, easy rebound: Drug expenditures with massive price cuts in Korea," Health Policy, Elsevier, vol. 123(4), pages 388-392.
    13. Håkonsen, Helle & Sundell, Karolina Andersson & Martinsson, Johan & Hedenrud, Tove, 2016. "Consumer preferences for over-the-counter drug retailers in the reregulated Swedish pharmacy market," Health Policy, Elsevier, vol. 120(3), pages 327-333.
    14. Sabine Vogler & Valérie Paris & Alessandra Ferrario & Veronika J. Wirtz & Kees Joncheere & Peter Schneider & Hanne Bak Pedersen & Guillaume Dedet & Zaheer-Ud-Din Babar, 2017. "How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries," Applied Health Economics and Health Policy, Springer, vol. 15(3), pages 307-321, June.
    15. Sabine Vogler, 2019. "Fair prices for medicines? Exploring competent authorities’ and public payers’ preferences on pharmaceutical policies," Empirica, Springer;Austrian Institute for Economic Research;Austrian Economic Association, vol. 46(3), pages 443-469, August.
    16. Chen, Xu & Yang, Huan & Wang, Xiaojun, 2019. "Effects of price cap regulation on the pharmaceutical supply chain," Journal of Business Research, Elsevier, vol. 97(C), pages 281-290.
    17. Else-Lydia Toverud & Katrin Hartmann & Helle Håkonsen, 2015. "A Systematic Review of Physicians’ and Pharmacists’ Perspectives on Generic Drug Use: What are the Global Challenges?," Applied Health Economics and Health Policy, Springer, vol. 13(1), pages 35-45, August.
    18. Juan Llano & Jorge Mestre-Ferrandiz & Jaime Espin & Jordi Gol-Montserrat & Alicia Llano & Carlos Bringas, 2022. "Public health policies for the common interest: rethinking EU states’ incentives strategies when a pandemic reshuffles all interests," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(3), pages 329-335, April.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:124:y:2020:i:12:p:1297-1309. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.