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Volume 6
Issue 1
10.1080/20016689.2018.1478539
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Journal of Market Access & Health Policy (JMAHP) is published by MDPI from Volume 12 Issue 1 (2024). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Taylor & Francis.
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Review

Approaches to Manage ‘Affordability’ of High Budget Impact Medicines in Key EU Countries

by
Mathias Flume
1,
Marc Bardou
2,
Stefano Capri
3,
Oriol Sola-Morales
4,
David Cunningham
5,
Lars-Ake Levin
6,
Maarten J. Postma
7 and
Nicolas Touchot
8,*
1
Kassenärztliche Vereinigung Westfalen-Lippe (KVWL), Dortmund, Germany
2
CIC INSERM 1432, CHU CHU Dijon-Bourgogne, Dijon Cedex, France
3
School of Economics and Management, Cattaneo-LIUC University, Castellanza (Varese), Italy
4
Health Innovation Technology Transfer, Barcelona, Spain
5
Cunningham Healthcare Advisory, Croydon, Surrey, UK
6
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
7
Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
8
groupH, 7 Mercier Road, London SW15 2AW, UK
*
Author to whom correspondence should be addressed.
J. Mark. Access Health Policy 2018, 6(1), 1478539; https://doi.org/10.1080/20016689.2018.1478539
Submission received: 2 March 2018 / Revised: 1 January 2018 / Accepted: 14 May 2018 / Published: 8 June 2018

Abstract

Background: The launch of hepatitis C (HCV) drugs such as sofosbuvir or ledipasvir has fostered the question of affordability of novel high budget impact therapies even in countries with high domestic product. European countries have developed a variety of mechanisms to improve affordability of such therapies, including ‘affordability thresholds’, price volume agreements or caps on individual product sales, and special budgets for innovative drugs. While some of these mechanisms may help limit budget impact, there are still significant progresses to be made in the definition and implementation of approaches to ensure affordability, especially in health systems where the growth potential in drug spending and/or in the patient contribution to health insurance are limited. Objectives: In this article, we will review how seven countries in western Europe are approaching the question of affordability of novel therapies and are developing approaches to continue to reward new sciences while limiting budget impact. We will also discuss the question of affordability of cost-effective but hugely expensive therapies and the implications for payers and for the pharmaceutical industry. Results: There is clearly not one solution that is used consistently across countries but rather a number of ‘tools’ that are combined differently in each country. This illustrates the difficulty of managing affordability within different legal frameworks and within different health care system architectures.
Keywords: budget impact; affordability; cost effectiveness; market access; funding; expensive therapies; health technology assessment; price negotiation budget impact; affordability; cost effectiveness; market access; funding; expensive therapies; health technology assessment; price negotiation

Share and Cite

MDPI and ACS Style

Flume, M.; Bardou, M.; Capri, S.; Sola-Morales, O.; Cunningham, D.; Levin, L.-A.; Postma, M.J.; Touchot, N. Approaches to Manage ‘Affordability’ of High Budget Impact Medicines in Key EU Countries. J. Mark. Access Health Policy 2018, 6, 1478539. https://doi.org/10.1080/20016689.2018.1478539

AMA Style

Flume M, Bardou M, Capri S, Sola-Morales O, Cunningham D, Levin L-A, Postma MJ, Touchot N. Approaches to Manage ‘Affordability’ of High Budget Impact Medicines in Key EU Countries. Journal of Market Access & Health Policy. 2018; 6(1):1478539. https://doi.org/10.1080/20016689.2018.1478539

Chicago/Turabian Style

Flume, Mathias, Marc Bardou, Stefano Capri, Oriol Sola-Morales, David Cunningham, Lars-Ake Levin, Maarten J. Postma, and Nicolas Touchot. 2018. "Approaches to Manage ‘Affordability’ of High Budget Impact Medicines in Key EU Countries" Journal of Market Access & Health Policy 6, no. 1: 1478539. https://doi.org/10.1080/20016689.2018.1478539

APA Style

Flume, M., Bardou, M., Capri, S., Sola-Morales, O., Cunningham, D., Levin, L. -A., Postma, M. J., & Touchot, N. (2018). Approaches to Manage ‘Affordability’ of High Budget Impact Medicines in Key EU Countries. Journal of Market Access & Health Policy, 6(1), 1478539. https://doi.org/10.1080/20016689.2018.1478539

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