ASSESSMENT OF FEASIBILITY OF THE METHODOLOGICAL APPROACH DESCRIBED IN THE MODEL FOR THE REGULATION OF REIMBURSEMENT PRICES IN GERMANY
Author(s)
Aidelsburger P1, Benkert D1, Neumann A2, Niebuhr D3, Wasem J21CAREM GmbH, Sauerlach, Germany, 2University of Duisburg-Essen, Essen, Germany, 3University of Applied Sciences Fulda, Fulda, Germany
OBJECTIVES: The generic drug market within the statutory health insurance (SHI) in Germany is affected by price regulations like fixed amounts or rebats. Legal amendments led to an increasing importance of price discounts with uncertain impact on pharmaceutical supply of the patients. To assure a justifiable price for the pharmaceutical companies and high quality a model has been developed by the Federal Association of Medicines Manufacturers e. V. (BAH) for the regulation of reimbursement prices, e.g. cost-benefit based price corridors. Aim of the study is to test the described methods for feasibility. METHODS: The prior published methods for the development of reimbursement price corridors are applied and tested for feasibility by use of the indication Gastroesophageal Reflux Disease (GERD). The methods intend the derivation of one or more corridors following a defined decision algorithm based on primary and secondary benefit criteria. Therefore a systematic assessment of benefits of proton pump inhibitors (PPIs), H2-Blockers and sucralfat is the foundation of further decisions concerning the number of corridors to consider. Several methodical approaches for the definition of height of each corridor are tested. RESULTS: PPIs are more effective than H2-Blocker or sucralfat concerning primary benefit endpoints. The assessment is based on secondary literature for financial and time reasons that will be relevant when implementing the model in real decision problems, too. Based on the results of the benefit assessment two corridors were implemented into the model. The height of each corridor can be derivated by use of angles as well as by other mathematical parameters like mean, quartiles etc. Both approaches show specific limitations. CONCLUSIONS: The feasibility of the reported concept can be shown. Several limitations, e.g. assessment of benefits based on secondary literature should be considered. Use of angles or mathematical parameter should be discussed with decision makers before implementation.
Conference/Value in Health Info
2010-11, ISPOR Europe 2010, Prague, Czech Republic
Value in Health, Vol. 13, No. 7 (November 2010)
Code
PGI30
Topic
Health Policy & Regulatory
Topic Subcategory
Reimbursement & Access Policy
Disease
Gastrointestinal Disorders