PCN97 IMPACT OF GLOBAL HEALTH CARE REFORMS ON PRICING, ACCESS AND HEALTH ECONOMICS AND OUTCOMES STRATEGY

Abstract

During 2009-2010 major healthcare reforms were proposed and implemented in a number of nations, for example, Affordable Care Act in the US, AMNOG in Germany, HSPT in France, KVG in Switzerland and NHS proposed reform in the UK. These reforms have major implications on pricing, market access and HEOR strategy for drug and device products. To understand the implications of these trends, we analyzed 2009-2010 reform bills and proposed changes worldwide. Additionally, we interviewed public and private payers, key opinion leaders and payer-influencers to understand implications of these reforms on drug and device manufacturers. The global healthcare landscape is expected to undergo significant change during 2011-2015. In the US, government will play increased role as a single payer, especially with–Medicare, Medicaid and CHIP programs– which will cover 114 million Americans, at a cost of $784 billion. In Germany, AMNOG bill marked the end of free drug pricing and would lead to increased insurance premiums (now 15.5% of wages). In the UK, NHS has proposed to replace PCTs with 500-1000 GP-led consortia and use value-based pricing for expensive drugs and devices. Overall, payers view that in the future, health economic assessments would play critical role in pricing, coverage and reimbursement of branded products. This analysis shows that global healthcare landscape is expected to undergo significant change during 2011-2015. Discussions with payers, KOLs and payer-influencers highlights increased importance of HEOR data in the future.