Decision-making Processes Related to Drug Pricing and Reimbursement. Is Poland Far Away from Global Standards?

• Autorzy: Robert Kranc , Marcin Czech
• Języki publikacji: EN

Abstrakty

EN

A substantial funding from healthcare budgets in the majority of countries is devoted to drugs. In order to make the best use of these scarce public resources, special agencies were established in order to assess efficacy, effectiveness, safety and cost-effectiveness of drugs. Based on their recommendations decisions regarding pricing and reimbursement are made coupled with guidelines for prescribers. Decisions of four agencies: Common Drug Review (CDR) from Canada, the National Institute for Health and Clinical Excellence (NICE) from the UK, Pharmaceutical Benefits Advisory Committee (PBAC) from Australia, Polish Agency of Health Technology Assessment (AOTM) were analysed and compared, main difficulties and controversies of decision making process were discussed. Two case studies were added for more detailed analysis.(original abstract)

Słowa kluczowe

EN

Prices; Medications; Payment for medications; Medical technology

PL

Ceny; Leki; Odpłatność za leki; Technologia medyczna

• Czasopismo: Journal of Health Policy and Outcomes Research
• Rocznik: 2012
• Numer: nr 1
• Strony: 29--38

Twórcy

autor

Robert Kranc

• School of Medical Science in Białystok

autor

Marcin Czech

• Warsaw Medical University Polish Society of Pharmacoeconomics,

Bibliografia

• Canadian Institute for Health Information. Drug Expenditure in Canada, 1985 to 2006.
• Ottawa, ON: Canadian Institute for Health Information; 2007
• Canadian Agency for Drugs and Technologies in Health. CADTH Presentation on the Common Drug Review to the House of Commons Standing Committee on Health. Ottawa, ON: Canadian Agency for Drugs and Technologies in Health; 2007
• Duerden M., Gogna N., Godman B., Eden K., Mallinson M., Sullivan N. Current national initiatives and policies to control drug costs in Europe: UK perspective. J Ambul Care Manage. 2004; 27(2): 132-138
• Health expenditure Australia 2006-07 [Health and welfare expenditure series No. 35]. Australian Institute of Health and Welfare. Available from: http://www.aihw.gov.au/publications/index.cfm/title/10659; [Accessed: September 10, 2009]
• Poisal JA. Medicaid drugs. Health Care Financ Rev. 2004; 25(3): 1-4
• Sales MM., Cunningham FE., Glassman PA., Valentino MA., Good CB. Pharmacy benefits management in the Veterans Health Administration: 1995 to 2003. Am J Manag Care. 2005; 11(2): 104-112
• The budget and economic outlook: fiscal years 2009 to 2019. Congressional Budget Office. Available from: http://www.cbo.gov/ftpdocs/99xx/doc9957/toc.htm; [Accessed: September 3, 2009]
• Collier J. Parliamentary review asks NICE to do better still. BMJ. 2008; 336(7635): 56-57
• Miners AH., Garau M., Fidan D., Fischer AJ. Comparing estimates of cost effectiveness submitted to the National Institute for Clinical Excellence (NICE) by different organisations: retrospective study. BMJ. 2005; 330(7482): 65
• Morgan SG., McMahon M., Mitton C. et al. Centralized drug review processes in Australia, Canada, New Zealand, and the United Kingdom. Health Aff (Millwood). 2006; 25(2): 337-347
• Steinbrook R. Saying no isn't NICE: the travails of Britain's National Institute for Health and Clinical Excellence. N Engl J Med. 2008; 359(19): 1977-1981
• Harris AH., Hill SR., Chin G., Li JJ., Walkom E. The role of value for money in public insurance coverage decisions for drugs in Australia: a retrospective analysis 1994-2004. Med Decis Making. 2008; 28(5):.713-722
• Henry DA., Hill SR., Harris A. Drug prices and value for money: the Australian Pharmaceutical Benefits Scheme. JAMA. 2005; 294(20): 2630-2632
• Hill SR., Mitchell AS., Henry DA. Problems with the interpretation of pharmacoeconomic analyses: a review of submissions to the Australian Pharmaceutical Benefits Scheme. JAMA. 2000; 283(16): 2116-2121
• Tierney M., Manns B. Members of the Canadian Expert Drug Advisory Committee. Optimizing the use of prescription drugs in Canada through the Common Drug Review. CMAJ. 2008; 178(4): 432-435
• McMahon M., Morgan S., Mitton C. The Common Drug Review: a NICE start for Canada? Health Policy. 2006; 77(3): 339-351
• Available from: http://www.pmprb-cepmb.gc.ca/english/home.asp?x=1; [Accessed: July 7, 2011]
• Available from: http://www.nice.org.uk; [Accessed August 7, 2011]
• Czech M. Farmakoekonomika jako narzędzie zarządzania w gospodarowaniu lekami w Polsce. Instytut Przedsiębiorczości i Samorządności. Warsaw 2006
• Available from: http://www.adelaide.edu.au/ahta/whatwedo; [Accessed August 10, 2011]
• Clement FM., Harris A., Li JJ., Yong K., Lee KM., Manns BJ. Using effectiveness and cost-effectiveness to make drug coverage decisions: a comparison of Britain, Australia, and Canada. JAMA. 2009 Oct 7; 302(13): 1437-43
• American College of Rheumatology Committee to Reevaluate Improvement Criteria. A proposed revision to the ACR20: the hybrid measure of American College of Rheumatology response. Arthritis Rheum. 2007; 57(2): 193-202
• Fleming TR., DeMets DL. Surrogate end points in clinical trials: are we being misled? Ann Intern Med. 1996; 125(7): 605-613
• Manns BJ., Owen WF Jr, Winkelmayer WC., Devereaux PJ., Tonelli M. Surrogate markers in clinical studies: problems solved or created? Am J Kidney Dis. 2006; 48(1): 159-166
• Hill S., Henry D., Mitchell A. Problems in pharmacoeconomic analyses. JAMA. 2000; 284(15): 1922-1924
• Chalkidou K., Tunis S., Lopert R., Rochaix L., Sawicki PT., Nasser M., Xerri B. Comparative effectiveness research and evidence-based health policy: experience from four countries. Milbank Q. 2009; 87(2): 339-367
• International pharmaceutical price differences: research report [2001]. Australian Government. Available from: http://www.pc.gov.au/projects/study/pbsprices/docs/finalreport; [Accessed September 3, 2009]
• National Institute for Health and Clinical Excellence. First Report of the Health Committee 2007-2008. London, United Kingdom: Stationary Office; 2008
• Williams I., Bryan S., McIver S. How should cost effectiveness analysis be used in health technology coverage decisions? Evidence from the National Institute for Health and Clinical Excellence approach. J Health Serv Res Policy. 2007; 12(2): 73-79
• Available from: http://www.egospodarka.pl/64189,Rynek-farmaceutyczny-w-Polsce-2011-2013,1,39,1.html;
• Available from: www.mz.gov.pl; [Accessed March 20, 2012

Identyfikatory

DOI

10.7365/JHPOR.2012.1.7