GLOBAL HEALTH CARE REFORMS AND PRICING, ACCESS AND HEALTH OUTCOMES STRATEGY

Author(s)

Aggarwal SNovel Health Strategies, Bethesda, MD, USA

OBJECTIVES: During 2009-2011 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. METHODS: To understand the implications of these trends, we analyzed 2009-2011 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. Stakeholders ranked various data collection methods on a scale of 1-10 (1-least important and 10-most important) RESULTS: The global healthcare landscape is expected to undergo significant change during 2012-2016. 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. Randomized controlled trial, budget impact model and systematic reviews —ranked highest (7.5-9.1) among payers. Overall, payers view that in the future, health economic assessments would play critical role in pricing, coverage and reimbursement of branded products. CONCLUSIONS: This analysis shows that global healthcare landscape is expected to undergo significant change during 2012-2016. Discussions with payers, KOLs and payer-influencers highlights increased importance of HEOR data in the future.

Conference/Value in Health Info

2011-11, ISPOR Europe 2011, Madrid, Spain

Value in Health, Vol. 14, No. 7 (November 2011)

Code

PHP103

Topic

Health Policy & Regulatory

Topic Subcategory

Reimbursement & Access Policy

Disease

Multiple Diseases

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