Indication-based pricing of the pharmaceuticals in Croatia: case-study.

IF 1.8 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Expert Review of Pharmacoeconomics & Outcomes Research Pub Date : 2025-03-14 DOI:10.1080/14737167.2025.2478232

Ana Bobinac, Luka Vončina, Ismar Velić, Elizabeta Ribarić, Vanesa Benković

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Abstract

Background: Rising pharmaceutical expenditure worldwide, including in Croatia, is putting considerable pressure on healthcare budgets. Oncology drugs, often used in several indications with varying efficacy, contribute to this challenge, and a single price is paid regardless of the indication. This study investigates whether indication-based pricing (IBP), a method of pricing the same drug for different indications based on its relative value in different treatment applications, could be a potential solution to contain drug expenditure.

Research design and methods: We operationalized IBP in two ways: by anchoring all drug prices according to the indication that provides the most or least benefit, and second, by anchoring drug prices to a cost-effectiveness threshold estimated for Croatia. We also interviewed policymakers in Croatia to determine whether they are familiar with the problem of differential effectiveness of medicines with multiple indications.

Results: Applying IBP to the oncology drug abiraterone in three indications, as measured by life-years gained (LYGs) and quality-adjusted life-years (QALYs), shows the effectiveness of abiraterone varies considerably by indication. Depending on the IBP approach chosen, drug prices can be reduced by 74% or increased by up to 280%.

Conclusions: Drug prices can vary dramatically depending on the IBP approach chosen.

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克罗地亚基于适应症的药品定价：案例研究。

背景：包括克罗地亚在内的世界范围内不断上升的药品支出正在给卫生保健预算带来相当大的压力。肿瘤药物通常用于多种适应症，疗效不同，这对这一挑战也有影响，而且无论适应症如何，都要支付单一价格。本研究探讨了基于适应症的定价（IBP）是否可能成为一种控制药物支出的潜在解决方案。IBP是一种根据不同治疗应用中的相对价值对同一药物的不同适应症进行定价的方法。研究设计和方法：我们以两种方式实施IBP：根据提供最多或最少益处的适应症固定所有药品价格，第二，将药品价格固定在为克罗地亚估计的成本效益阈值上。我们还采访了克罗地亚的政策制定者，以确定他们是否熟悉具有多种适应症的药物的差异有效性问题。结果：以获得生命年（LYGs）和质量调整生命年（QALYs）衡量，将IBP应用于肿瘤药物阿比特龙的三个适应症，显示阿比特龙的有效性因适应症而有很大差异。根据所选择的IBP方法，药品价格可降低74%或最多增加280%。结论：根据IBP方法的选择，药品价格可能会有很大差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Pharmacoeconomics & Outcomes Research HEALTH CARE SCIENCES & SERVICES-PHARMACOLOGY & PHARMACY

CiteScore

4.00

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Expert Review of Pharmacoeconomics & Outcomes Research (ISSN 1473-7167) provides expert reviews on cost-benefit and pharmacoeconomic issues relating to the clinical use of drugs and therapeutic approaches. Coverage includes pharmacoeconomics and quality-of-life research, therapeutic outcomes, evidence-based medicine and cost-benefit research. All articles are subject to rigorous peer-review. The journal adopts the unique Expert Review article format, offering a complete overview of current thinking in a key technology area, research or clinical practice, augmented by the following sections: Expert Opinion – a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.