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Il prezzo di riferimento nel quadro regolatorio del mercato farmaceutico

  • Chiara Bonassi

    (Autorità Garante della Concorrenza e del Mercato)

  • Laura Magazzini


    (Department of Economics, University of Verona)

  • Fabio Pammolli


    (IMT Lucca Institute for Advanced Studies and CERM Foundation - Competitività, Regole, Mercati)

  • Massimo Riccaboni


    (IMT Lucca Institute for Advanced Studies and and Department of Managerial Economics, Strategy and Innovation, K.U. Leuven)

  • Nicola Carmine Salerno


    (EIOPA - European Insurance and Occupational Pensions Authority)

La letteratura suggerisce che l'applicazione del reference pricing avvenga solo sugli off-patent, sulla base di cluster chimico-terapeutico-biologici, con prezzo di rimborso allineato a quello del prodotto più economico. Non mancano, tuttavia, segnalazioni di criticità, riconducibili alle caratteristiche del contesto istituzionale e regolatorio. Tra queste, anche l’assenza di copayment percentuale sugli in-patent e sugli off-patent con prezzo allineato a quello di rimborso, nonché l'assenza di regole di pricing (in ammissione in fascia "A") e di governance annuale della spesa coerenti con la tipologia (innovazione significativa/incrementale, copia) e il "ciclo di vita" dei farmaci. Per quanto riguarda l'Italia, i dati sulle dinamiche di prezzo e sugli ingressi di nuovi produttori/prodotti sul mercato, nonché le recenti scoordinate sovrapposizioni Stato-Regioni nella gestione dello strumento, offrono una visione "luci ed ombre" dell'applicazione del reference pricing. L'attenzione va quegli snodi critici che più volte sono stati segnalati nel corso dei lavori del CERM e che questo Quaderno è occasione per ribadire.

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Paper provided by Competitività Regole Mecati (CERM) in its series Working Papers with number 04-2007.

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Length: 60 pages
Date of creation: Dec 2007
Date of revision:
Handle: RePEc:ern:wpaper:04-2007
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  1. Kurt R. Brekke & Ingrid Königbauer & Odd Rune Straume, 2006. "Reference Pricing of Pharmaceuticals," CESifo Working Paper Series 1825, CESifo Group Munich.
  2. Thomas Aronsson & Mats Bergman & Niklas Rudholm, 2001. "The Impact of Generic Drug Competition on Brand Name Market Shares – Evidence from Micro Data," Review of Industrial Organization, Springer, vol. 19(4), pages 423-433, December.
  3. Lisa L. Ioannides-Demos & Joseph E. Ibrahim & John J. McNeil, 2002. "Reference-Based Pricing Schemes: Effect on Pharmaceutical Expenditure, Resource Utilisation and Health Outcomes," PharmacoEconomics, Springer Healthcare | Adis, vol. 20(9), pages 577-591.
  4. Paul V. Grootendorst & Lisa R. Dolovich & Anne M. Holbrook & Adrian R. Levy & Bernie J. O'Brien, 2002. "The Impact of Reference Pricing of Cardiovascular Drugs on Health Care Costs and Health Outcomes: Evidence from British Columbia--Volume I: Summary," Social and Economic Dimensions of an Aging Population Research Papers 70, McMaster University.
  5. Patricia M. Danzon & Jonathan D. Ketcham, 2003. "Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands and New Zealand," NBER Working Papers 10007, National Bureau of Economic Research, Inc.
  6. Danzon, Patricia M & Chao, Li-Wei, 2000. "Does Regulation Drive out Competition in Pharmaceutical Markets?," Journal of Law and Economics, University of Chicago Press, vol. 43(2), pages 311-57, October.
  7. Ghislandi, Simone & Krulichova, Iva & Garattini, Livio, 2005. "Pharmaceutical policy in Italy: towards a structural change?," Health Policy, Elsevier, vol. 72(1), pages 53-63, April.
  8. Giuliani, Giovanni & Selke, Gisbert & Garattini, Livio, 1998. "The German experience in reference pricing," Health Policy, Elsevier, vol. 44(1), pages 73-85, April.
  9. Nina Pavcnik, 2002. "Do Pharmaceutical Prices Respond to Potential Patient Out-of-Pocket Expenses?," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 469-487, Autumn.
  10. Desmond Sheridan & Jim Attridge, 2006. "The Impact of Therapeutic Reference Pricing on Innovation in Cardiovascular Medicine," PharmacoEconomics, Springer, vol. 24(2), pages 35-54, December.
  11. Zweifel, Peter & Crivelli, Luca, 1996. "Price Regulation of Drugs: Lessons from Germany," Journal of Regulatory Economics, Springer, vol. 10(3), pages 257-73, November.
  12. Puig-Junoy, Jaume, 2004. "Incentives and pharmaceutical reimbursement reforms in Spain," Health Policy, Elsevier, vol. 67(2), pages 149-165, February.
  13. Lopez-Casasnovas, Guillem & Puig-Junoy, Jaume, 2000. "Review of the literature on reference pricing," Health Policy, Elsevier, vol. 54(2), pages 87-123, November.
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