Abstract
BackgroundIncreasing health costs in developed countries are a major concern for decision makers. A variety of cost containment tools are used to control this trend, including maximum price regulation and reimbursement methods for health technologies. Information regarding expenditure-related outcomes of these tools is not available.ObjectiveTo evaluate the association between different cost-regulating mechanisms and national health expenditures in selected countries.MethodsPrice-regulating and reimbursement mechanisms for prescription drugs among OECD countries were reviewed. National health expenditure indices for 2008–2012 were extracted from OECD statistical sources. Possible associations between characteristics of different systems for regulation of drug prices and reimbursement and health expenditures were examined.ResultsIn most countries, reimbursement mechanisms are part of publicly financed plans. Maximum price regulation is composed of reference-pricing, either of the same drug in other countries, or of therapeutic alternatives within the country, as well as value-based pricing (VBP). No association was found between price regulation or reimbursement mechanisms and healthcare costs. However, VBP may present a more effective mechanism, leading to reduced costs in the long term.ConclusionsMaximum price and reimbursement mechanism regulations were not found to be associated with cost containment of national health expenditures. VBP may have the potential to do so over the long term.
Highlights
IntroductionPharmaceutical spending across OECD countries was approximately United States (US) $800 billion in 2013, accounting for 17 % of total health spending [1]
Trends in drug expendituresPharmaceutical spending across OECD countries was approximately United States (US) $800 billion in 2013, accounting for 17 % of total health spending [1]
Background Increasing health costs in developed countries are a major concern for decision makers
Summary
Pharmaceutical spending across OECD countries was approximately US $800 billion in 2013, accounting for 17 % of total health spending [1]. Drug costs among OECD countries accounted for 17 % of total health expenditures in 2013, with wide variations [3]; starting at less than 10 % in Denmark and Norway, and up to more than 30 % in Hungary (Fig. 1). Wide variations in pharmaceutical spending per capita across countries reflect differences in volume, patterns of consumption, and prices. The increasing availability of new high-cost drugs, combined with population aging, suggests that pharmaceutical expenditures may increase once again after stagnation in the past decade [1]. While some high-price drugs have considerable benefits, others provide only marginal improvements to patient outcomes. Information regarding expenditurerelated outcomes of these tools is not available
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