本報告已在2011年12月21日停止出版。
1989年德國政府為了抑制製藥產業的高漲藥價，開始採用參考價格的制度。現在歐洲各國也利用參考價格制度作為抑制處方藥價格的手段。
專門於醫療產業相關廣泛調查的美國市調公司 Decision Resources Inc. (總公司：Massachusetts State) ，針對歐洲參考價格制度的課題進行調查分析，並整理出版報告書 "The Challenges of Reference Pricing in Europe" 。
本報告書內容包括:歐洲各國的參考價格制度概要、與非專利藥品的競爭、參考價格制度對德國施德丁類藥品市場產生的影響、德國醫生對參考價格制度的看法、未來發展預測等。內容綱要摘記如下：
實施概要
介紹
德國
- 參考價格制度擴大適用於受專利保護的藥物
- 更積極的參考價格方法
- 參考價格調降主導權
- 2007年的價格調整
- 對市場的影響
荷蘭
西班牙
義大利
法國
藥品產業未來發展預測及影響
補充資料
- 與非專利藥品競爭產生的影響及參考價格對德國施德丁類藥品市場產生的影響
- 針對參考價格的正反兩面意見
- 德國醫生對參考價格的看對：從施德丁類藥品市場得到的教訓
表
- 德國適用參考價格的目標藥物中的自我負擔
- 德國利用參考價格累積下來的儲蓄金額：1989年至2007年
- 德國藥品市場中利用參考價格目標藥物的普及率：2004年至2006年
圖
- 德國採用參考價格的目標藥物：個別的參考價格及與其比較的零售價格
- 德國規定醫療保險目標藥品市場中參考價格目標藥物的銷售金額及市場占有率
- 西班牙的參考價格目標藥物：藥價與參考價格之間的關係
Abstract
Introduction:
In 1989, the German government introduced reference pricing as a
cost-containment strategy for the pharmaceutical industry' s high prices of
drugs. Now, much of Europe employs reference pricing as a means to rein in the
prices of prescription drugs. Pharmaceutical companies have been forced to
decide whether to cut their prices in order to match reference prices, or
maintain higher prices-thereby gambling that the money lost due to lower
prescribing volumes will be more than offset by the money gained by the price.
Meanwhile, patients have been caught in a web of new pricing systems that may
be creating a two-class system of health care.
Get the Answers You Need to Shape Your Strategy:
- The German government recently began waiving patients' out-of-pocket
payments on thousands of pharmaceutical products. Which category of drugs
could be severely disadvantaged by these waivers?
- In 2004, Pfi zer denounced Germany' s GBA for including patent-protected
medicines in “jumbo” reference pricing groups, thereby subjecting
Sortis (atorvastatin) to reference prices. What pricing strategy did Pfi zer
ultimately use to defend Sortis? What was the effect of Pfi zer' s strategy on
Sortis' s market share?
- Regional governments in Italy have some discretion when deciding
reimbursement terms for reference-priced medicines. Why has the Italian Drugs
Agency recently expressed concern that some regions in Italy may be abusing
their discretionary privilege?
Scope:
Germany: The three levels of reference pricing; off-patent and
patent-protected drugs; the introduction of more aggressive reference prices;
statins, sartans, and PPIs; incentives to undercut reference prices; 2007 price
adjustments; market impact and pricing trends; cumulative savings from
reference pricing; penetration of reference-priced drugs into the German
pharmaceutical market.
Netherlands: Pharmaceutical Reimbursement System (GVS);
interchangeability; Annexes 1A and 1B; recommendations for reform from the
Health Care Insurance Board (CVZ).
Spain: Conjuntos homogéneos; the 2004 suspension of reference
pricing; implementation of a new reference pricing system in March 2007.
Italy: The 1994 Finance Act; price and reimbursement ceilings; regional
governments; categorie terapeutiche omogenee; reimbursement ceilings for
off-patent and patent-protected drugs.
France: The fi rst and second waves; radical reform; drugs exceeding
reference price levels; the moderation of off-patent prices; impact on
pharmaceutical expenditures.
Sidebars: Three featured discussions concerning the impact of generics
competition and reference pricing on the German statin market; the
consequences of reference price alignment; and German physicians' views on
reference pricing.
Outlook: imposition of maximum reimbursement sums for costly drugs in
Germany; projected savings in Spain; prospects for a more aggressive system in
the Netherlands; regional variations in Italy; focus on generics dispensing
rates in France; proposed introduction of reference pricing in the United
Kingdom.
Table of Contents
- Executive Summary
- Strategic Considerations
- Stakeholder Implications
- Introduction
- Germany
- Extension of Reference Pricing to Patent-Protected Drugs
- A More Aggressive Reference Price Method
- Incentives to Undercut Reference Prices
- Price Adjustments in 2007
- Market Impact
- Netherlands
- Spain
- Italy
- France
- Outlook and Implications for the Pharmaceutical Industry
Sidebars
- The Impact of Generics Competition and Reference Pricing on the German
Statin Market-A Cautionary Tale
- To Cut or Not to Cut-The Pros and Cons of Reference Price Alignment
- German Physicians' Views on Reference Pricing-Lessons from the Statin
Market
Tables
- 1. Out-of-Pocket Payments for Reference-Priced Drugs in Germany
- 2. Cumulative Savings from Reference Pricing in Germany, 1989-2007
- 3. Penetration of Reference-Priced Drugs into the German Pharmaceutical
Market, 2004-2006
- 4. Drugs Exceeding Their Reference Prices in France (June 1, 2005)
Figures
- 1. Reference-Priced Drugs in Germany: Percentage of Drugs with Retail
Prices Above, In Line With, and Below Their Respective Reference Prices
(January 1, 2007)
- 2. Total Sales and Prescription Shares of Reference-Priced Drugs in the
German Statutory Health Insurance Pharmaceutical Market, 1999-2005
- 3. Reference-Priced Drugs in Spain: Overall Relationship Between Drug
Prices and Their Reference Prices
- A. Consumption of Statins in the German Statutory Health Insurance Market,
2001-2005
- B. Proton Pump Inhibitors in the German Statutory Health Insurance
Pharmaceutical Market: Percentage Change in Price, Prescribing Volume, and
Sales (2004-2005)
- C. Sartans in the German Statutory Health Insurance Pharmaceutical Market:
Percentage Change in Price, Prescribing Volume, and Sales (2004-2005)
- D. Has Reference Pricing Created a Two-Class System for the Treatment of
Dyslipidemia in Germany? (Physician Responses)
- E. Physician Views of Actions Taken by GKV Patients Prescribed
Atorvastatin in 2005
