[article] Deciding on value for money : A comparison of the Dutch, Belgian, Swedish, and French drug reimbursement systems [printed text] / Margreet Franken, Author ; Maïté le Polain, Author ; Arnaud Senn, Author ; Marc Koopmanschap, Author ; Irina Cleemput  , Author . - 2010 . - A249. Languages : English ( eng) in Value in Health > 13(2010)7 [11/01/2010] . - A249 | Descriptors: |
Classification
W 1 Serials. Periodicals
Indexation
2009-19 ; Belgium ; Decision Making ; Drug Costs ; Economics ; France ; Journal Article ; Peer Review ; Pharmacology ; Policy ; R147 ; Reimbursement Mechanisms ; Sweden
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| Abstract: |
OBJECTIVES: Many countries are adapting their pharmaceutical reimbursement system, increasingly emphasizing the role of pharmacoeconomics in decision-making. The aim of our study is to analyze European regulatory systems to obtain insight into best practice systems that deliver value for money. METHODS: The analytical Hutton Framework was used for comparing and assessing “fourth hurdle” drug reimbursement systems in the The Netherlands, Belgium, Sweden, and France. We investigated policy documents, explored literature, and conducted interviews with policymakers and representatives of the pharmaceutical industry. RESULTS: All systems have a centralized decision body, even though the financial responsibility may be regional (Sweden). Only in Sweden, the minister has no role at the individual reimbursement decision level. None of the systems has a fully independent evaluation process and the impact of the systems is mainly assessed on drug expenditure. All countries make efforts to increase transparency. However, in Sweden manufacturers may withdraw their application before the final reimbursement decision, guaranteeing confidentiality at the cost of less transparency. Policies to deal with uncertainty vary per country: financial risk-sharing agreements by price/volume contracts-France-versus outcomes-based agreements for expensive inpatient drugs-the The Netherlands. The actual value of a drug and disease severity is reflected in the level of reimbursement in France and Belgium, whereas in the The Netherlands and Sweden, enlisted drugs are fully reimbursed. All countries attempt to increase the importance of pharmaco- economics in decision-making. However, no country expresses the relative importance of cost-effectiveness compared to other criteria nor applies a strictly defined threshold. CONCLUSIONS: This study reveals that while there is a convergence in scientific evaluation processes, important differences remain between the Dutch, Belgian, Swedish, and French regulatory frameworks. All countries recognize that pharmaco- economics has a place in decision-making on value for money, but for the time being, pharmacoeconomics seems to play a rather undefined role. |
| Link for e-copy: |
http://doi.org/10.1016/S1098-3015(11)71891-5 |
| Format of e-copy: |
PDF [Open Archive] |
| Record link: |
https://kce.docressources.info/index.php?lvl=notice_display&id=3740 |
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Add the result to your basket Make a suggestion Refine your search Apply to external sourcesAcceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy in Value in Health, 18(2015)04 ([06/01/2015])
Behavioural public policy / Cambridge [U.K.] : Cambridge University Press (2013)
