Age-related neurological disorders will impose increasing economic burdens on industrialized nations as their populations age. High prices fuel this market-$11 billion in 2005-but the growing use of these agents has prompted stringent cost-control measures. New drugs must demonstrate signifi cant advantages over current therapies if they are to secure favorable pricing and reimbursement in the future.

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U.S. sales will increase because of a surge in Medicare Part D participation, although this impact will be blunted by discounts and rebates elsewhere in the Medicare program. What techniques will Medicare Part D use to constrain prescription of neurology dugs? What impact will these techniques have on sales?
European health care systems frequently limit the prescription of neurology drugs, at least initially, to specialists-often in the hospital setting. What new restrictions will European physicians face in prescribing neurology drugs?
Japan has a limited number of neurology drugs, and this situation is unlikely to change during our forecast. What factors will continue to constrain growth in the Japanese market? Are there opportunities for novel neurology drugs in Japan?
Pricing and reimbursement for new neurology drugs will largely be dependent on their innovation. What methods do the various markets under study employ to set prices for neurology drugs? What additional impediments to pricing will emerge?
An emerging trend in all markets (for new and established therapies alike) is health technology assessment and health economic evaluation. Which countries under study already utilize these price-control techniques? What impact will this practice have on neurology therapies?

Scope

Indications covered: Alzheimer' s disease, epilepsy, multiple sclerosis, and Parkinson' s disease.
Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.
Price comparisons: comparisons of international pricing for the neurological drug classes in this report.
Reimbursement: overview of the general environment in each market and analysis of factors specifi c to individual neurological drug classes.
Market outlook: pricing and reimbursement implications for the manufacturers of neurology drugs.

Executive Summary
Strategic Considerations
Stakeholder Implications
Introduction
International Price Comparisons for Neurology Drugs
Overview
Dementia Therapies
Parkinson' s Disease Therapies
Sidebar: Memantine: New Life-and a New Price-for an Old Drug
Multiple Sclerosis Therapies
Antiepileptic Agents
Reformulations and "Me-Too" Drugs
Reimbursement Environment
United States
General Environment
Private Insurance
Medicare
Medicaid
Sidebar: Patient Assistance Programs-An Important Source of Drug Funding
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
France
General Environment
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
Germany
General Environment
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
Italy
General Environment
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
Spain
General Environment
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
United Kingdom
General Environment
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
Japan
General Environment
Dementia Therapies
Parkinson' s Disease Therapies
Multiple Sclerosis Therapies
Antiepileptic Agents
Outlook and Implications for the Pharmaceutical Industry
Sidebar: Generic Neurology Drugs-An Increasingly Competitive Market

Tables

1. Brand Names and Marketing Companies of Select Neurology Drugs
2. Ex-Manufacturer Prices of Select Neurology Drugs in Europe and Japan as a Percentage of the U.S. Price, 2005
3. Average Annual Exchange Rates Against the U.S. Dollar, 2001-2005
4. Prices of Reformulations of Dementia Therapies in the United States and Europe as a Percentage of the Price of the Original Formulations in Each Market, 2005
5. Prices of Dementia Therapies in the United States and Europe as a Percentage of the Price of Donepezil in Each Market, 2005
6. Health Insurance Coverage of the U.S. Population, 2002-2004
7. Formulary Positioning of Select Neurology Drugs in Five Leading Managed Care Organizations
8. Formulary Coverage of Select Neurology Drugs in National Medicare Prescription Drug Plans
9. Percentage of State Medicaid Programs Using Various Pharmaceutical Cost-Containment Measures, 2000, 2003, and 2005
10. State Medicaid Programs' Use of Preferred Drug Lists, August 2006
11. Status of Select Neurology Drugs in Five States' Preferred Drug Lists
12. Assessment of Select Neurology Drugs by France' s Medicines Evaluation Commission
13. Reference and Retail Prices of Select Doses and Pack Sizes of Neurology Drugs Subject to Reference Pricing in Germany, August 2006
14. Out-of-Pocket Payments for Reference-Priced Drugs in Germany
15. Patent Expiration Calendar for Select Neurology Drugs

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神經疾病治療藥的價格趨勢及償付

Pricing and Reimbursement Issues in Neurology

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