Abstract
BackgroundIn China, health technology assessment (HTA) has recently been adopted in pricing negotiation for medicine listing in the National Reimbursement Drug List. At present, how HTA is applied to inform the decision-making process remains underreported. In order to explore how the adoption of HTA was translated into listing and price negotiation results in light of the confidential nature of the negotiating process, this study aimed to compare the negotiated price and the clinical benefit of selected targeted anticancer medicines (TAMs) involved in the 2019 negotiation.Main textAmong 16 TAMs successfully negotiated, only four TAMs representing four indication groups had appropriate reference medicines for comparison and were, therefore, included in the analysis. The price and clinical benefit of the four TAMs were compared against one or two reference medicines with the same initial indications. The sales prices for nine TAMs before and after the negotiation were extracted from the centralized medication procurement system. Clinical benefits were evaluated based on evidence from published articles and clinical guidelines. The results suggested that, despite the application of HTA, both rational and irrational decisions had been made about the reimbursement of TAMs in the 2019 negotiation, warranting further investigation.ConclusionWhile the development and adoption of HTA has seen significant progress in China, actions are needed to ensure that the adoption of HTA is effectively applied in decisions on the reimbursement of medicines.
Highlights
Among 16 targeted anticancer medicines (TAMs) successfully negotiated, only four TAMs representing four indication groups had appropriate reference medicines for comparison and were, included in the analysis
In this study, high-priced TAMs were selected to explore the possible impact of health technology assessment (HTA) adopted in the pricing negotiation process on the treatment daily costs
A multicentre, single-arm, phase 2 trial showed that sintilimab was effective among Chinese patients, with 74 (80%) of 92 patients showing an objective response (OR) and 31 (34%) demonstrated complete remission (CR) [16, 17]
Summary
Among 16 TAMs successfully negotiated, only four TAMs representing four indication groups had appropriate reference medicines for comparison and were, included in the analysis. The price and clinical benefit of the four TAMs were compared against one or two reference medicines with the same initial indications. In China, health technology assessment (HTA) has recently been adopted in pricing negotiation for medicine listing in the National Reimbursement Drug List. In order to explore how the adoption of HTA was translated into listing and price negotiation results in light of the confidential nature of the negotiating process, this study aimed to compare the negotiated price and the clinical benefit of selected targeted anticancer medicines (TAMs) involved in the 2019 negotiation. Despite the emphasis on cost-effectiveness in the evaluation, it was not until the third revision of the NRDL in 2017 that pharmacoeconomic evaluation was adopted for the first time by the MHRSS as a negotiation tool during the decision-making process for medicine listing and pricing negotiation [8]
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