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What is Required to Evaluate the Impact of Pharmaceutical Reference Pricing?

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  • Jaume Puig-Junoy

    (Department of Economics and Business, Research Centre for Health and Economics (CRES), Pompeu Fabra University, Barcelona, Spain)

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    Abstract

    Objective: To describe empirical studies evaluating the impact of reference pricing (RP) interventions in pharmaceutical markets in order to discuss the requirements for these evaluations. Methods: Ten studies were included in this review. For each study, the nature of the intervention, the nature of the data available, the nature of the question to be answered and the requirements of the evaluation method were examined through a questionnaire. The most frequently used evaluation method was the conventional before-after estimator, and only three studies used the difference-in-differences method. Results: Nine studies evaluated a therapeutic RP system and one evaluated a generic RP system. All of the papers reported how the reference price level was established, but only one study directly reported the updating frequency and criteria of the RP system. In four studies, details of simultaneous interventions were not reported. There is no paper providing evidence on overall social welfare impact. Four papers estimated the impact of intervention on the consumer price of drugs covered by the RP system. Only one provided information about the impact on the price of related drugs not covered by the system. Three studies included an outcome variable for the use of health services. The impact of RP intervention on the level of competition in the market for those medicines covered by the system was reported in only three of ten papers. Discussion/conclusion: Despite the rigorous effort made to evaluate the impact of RP policies in some countries, several limitations may affect both their internal validity (the nature of the data available, statistical problems common to non-experimental data, etc.) and their external validity (heterogeneity in the nature of the intervention).

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    Bibliographic Info

    Article provided by Springer Healthcare | Adis in its journal Applied Health Economics and Health Policy.

    Volume (Year): 4 (2005)
    Issue (Month): 2 ()
    Pages: 87-98

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    Handle: RePEc:wkh:aheahp:v:4:y:2005:i:2:p:87-98

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    Web page: http://healtheconomics.adisonline.com/

    Related research

    Keywords: Cost-allocation; Cost-containment;

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    Cited by:
    1. Garattini, Livio & Cornago, Dante & De Compadri, Paola, 2007. "Pricing and reimbursement of in-patent drugs in seven European countries: A comparative analysis," Health Policy, Elsevier, Elsevier, vol. 82(3), pages 330-339, August.
    2. Tom Stargardt, 2010. "The impact of reference pricing on switching behaviour and healthcare utilisation: the case of statins in Germany," The European Journal of Health Economics, Springer, Springer, vol. 11(3), pages 267-277, June.
    3. Jaume Puig, 2005. "The impact of generic reference pricing interventions in the statin market," Economics Working Papers 906, Department of Economics and Business, Universitat Pompeu Fabra.
    4. Puig-Junoy, Jaume, 2007. "The impact of generic reference pricing interventions in the statin market," Health Policy, Elsevier, Elsevier, vol. 84(1), pages 14-29, November.
    5. Jaume Puig, 2005. "The impact of generic reference pricing interventions in the statin market," Working Papers, Research Center on Health and Economics, Department of Economics and Business, Universitat Pompeu Fabra 906, Department of Economics and Business, Universitat Pompeu Fabra.
    6. Kurt R. Brekke & Astrid L. Grasdal & Tor Helge Holmås, 2007. "Regulation and Pricing of Pharmaceuticals: Reference Pricing or Price Cap Regulation?," CESifo Working Paper Series 2059, CESifo Group Munich.
    7. Boris Augurzky & Silja Göhlmann & Stefan Gre� & Jürgen Wasem, 2009. "Effects of the German reference drug program on ex-factory prices of prescription drugs: a panel data approach," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 421-436.

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