Farmeconomia. Health economics and therapeutic pathways
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Marche
Get PDFIn Marche region 68% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 18 cases of cervicocarcinoma and 8 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (10,700 €/QALY)
How large are the differences between originator and generic prices? Analysis of five molecules in 16 European countries
Get PDFOBJECTIVE: To survey the price differences between originators and generics for a selected basket of molecules and to analyze similarities and differences with regard to the countries included and their generic policies. METHODS: Ex-factory prices as of November 2011 of five molecules provided from the Pharma Price Information (PPI) service of the Austrian Health Institute were analyzed for 16 European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, the Netherlands, Norway, Portugal, Spain, Switzerland, Sweden, UK). The selected molecules were gemcitabine, mycophenolate mofetil, olanzapine, risperidone and sumatriptan. For a specific presentation (same pack size, dosage and pharmaceutical form) of each molecule, the prices of the original product and the “most common generic” as defined by PPI were compared. RESULTS: Considerable variations among the extent of price differences between originator and generic were identified (gemicitabine: lowest price difference of 1.4% between originator and generic in Belgium and highest difference of 73.4% in Portugal; mycophenolate mofetil: 3.4% Norway – 71.7% Netherlands; olanzapine: 0.1% Spain – 97.1% Sweden; risperidone: 0.9% Netherlands – 97.3% UK; sumatriptan: 5.8% Greece – 95.0% Denmark). Further, no difference at all between originator and generic prices was found for some molecules in a few countries (Norway: for 4 of the 5 molecules analyzed; Spain: 3; Belgium: 2; in Austria, France and Greece for one molecule respectively). For the five molecules of the sample, Greece, Spain, Ireland and Norway consistently displayed lower price differences whereas Denmark, Finland and Sweden tended to show higher differences between originator and generic prices. CONCLUSION: Even if this research is illustrative and not representative due to the small sample size, results suggest confirming large differences across Europe. It appears that countries (e.g. Denmark, Sweden) with strong generic policies, particularly based on competition and involving elements of enforcement, tend to have higher differences between originator and generic prices. Further research, notably with a broader basket, is recommended
Essential to increase the use of generics in Europe to maintain comprehensive health care?
Get PDFINTRODUCTION: Reforms have been introduced across Europe to increase prescribing efficiency with existing drugs. These include measures to lower prices of generics as well as increase their prescribing versus originators and patented products in a class or related class. This is essential to maintain comprehensive health care in Europe given continued pressures. The alternative is insufficient funds for new innovative drugs and increasing drug volumes with ageing populations. OBJECTIVE: To review the influence of measures and initiatives to increase the prescribing and dispensing of generics at low prices on ambulatory care prescribing efficiency. In view of this, provide guidance as authorities strive to introduce further reforms to meet their goals. METHODOLOGY: A narrative review of published papers combined with case histories. RESULTS: The different supply- and demand-side measures have reduced generic prices to as low as 2% to 3% of pre-patent loss prices in some cases as well as appreciably enhanced their utilisation. As a result, prescribing efficiency has increased without compromising care. In some cases, the reforms have led to expenditure actually falling despite appreciably increased volumes. CONCLUSIONS: Increasing use of generics at low prices will help maintain the European ideals of comprehensive and equitable health care. However, countries will continually need to learn from each other
Sardegna
Get PDFIn Sardegna region 75% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 17 cases of cervicocarcinoma and 8 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (10,841 €/QALY)
From generic to biosimilar drugs: why take an innovative pace?
Get PDFBACKGROUND: The transition of the generic/biotechnology industry to innovation by investing in innovative R&D will enhance business expertise in biopharmaceutical development and manufacturing. The major impact of this evolution is on patient access to treatment and savings for the health care systems. OBJECTIVES: The aim of this paper is to investigate the innovative aspect of biosimilar and biobetter products, manufactured by some big generic companies. We will also try to explore the innovative business strategy, implementing this high risk product differentiation policy. METHODS: This qualitative research is conducted by a series of interviews with CEOs, physicians, and academics in different countries. The qualitative data obtained were analyzed by Nvivo9.2 software. A literature review has also contributed to our key findings. RESULTS: The results show that switching into biosimilars/biobetters is an innovative strategic choice, approved by some big generic pharmaceutical companies. The biosimilar/biobetter products can be considered innovative because of their value added quality. CONCLUSION: Expanding the product portfolio to biosimilars/biobetter can be considered as a long run strategy in the innovative business plans aiming to ensure the market access. Patients and their access to better treatments are major components of these innovative business models
Toscana
Get PDFIn Toscana region 83% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 27 cases of cervicocarcinoma and 12 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,466 €/QALY)
The effect of obesity upon Health Related Quality of Life (HRQoL): A comparison of the AQoL-8D and SF-36 instruments
Get PDFOBJECTIVES: The objective of this study was to describe and measure the loss of health related quality of life (HRQoL) associated with obesity using two generic instruments. The first of these, the SF-36, is the most widely used and validated HRQoL instrument worldwide. However, it does not provide utility weights and cannot be used to measure quality adjusted life years (QALYs), an increasingly common unit for comparing the effect of health states in economic evaluation studies. The second, the AQoL-8D, is a multi-attribute utility (MAU) instrument which was developed to increase sensitivity of previous MAU instruments to psycho-social dimensions of a health state and to allow the calculation of QALYs. Since the two instruments differ, an important additional objective of the study was to determine the validity of the AQoL-8D as judged by the SF-36, and therefore the confidence which might be placed upon its use in the context of obesity.METHODS: Data were obtained from patients waiting for bariatric surgery who had completed both the SF-36 and AQoL-8D quality of life instruments and a general questionnaire including height, weight, demographic and socio-economic information. For comparative purposes, scores were standardized using results from a representative sample of the general population. The content validity of the AQoL-8D was assessed by comparing it with the dimension scores from the SF-36 and the summary component (physical and mental) scores. Overall scores from the SF-36 and AQoL-8D instruments were regressed upon patient BMI and the results from the AQoL-8D used to estimate the effect of overweight and obesity upon utility and lost QALYs.RESULTS: The comparison of the instruments indicated that the AQoL-8D has good convergent, concurrent and content validity. Using both instruments, obesity was significantly associated with lower scores for 14 of their 16 dimensions. AQoL-8D, in particular, identified a significant decrease in psychological and social health with happiness, self-worth, coping and mental health, all being poorer than in the control group. Regression results implied that a change in BMI from 30 to 50 decreases utility by 0.12 or by 13.8 percent of the average utility for a 25-35 year old.CONCLUSION: AQoL-8D is a valid measure of utility in the context of obesity. Its inclusion of psycho-social effects significantly increases the measured adverse effects of obesity
Friuli-Venezia Giulia
Get PDFIn Friuli-Venezia Giulia region 86% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 8 cases of cervicocarcinoma and 3 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,960 €/QALY)
Piemonte
Get PDFIn Piemonte region 82% of women (aged 24-64) are screened regularly, meaning every 3 years. The analysis on cross-protective activity exercised by bivalent and quadrivalent vaccines shows that the bivalent vaccine could prevent more pre-cancerous lesions and cases of cervicocarcinoma than quadrivalent, and that the latter could prevent genital warts that are not prevented by bivalent. The major number of cases avoided by the bivalent make it possible to fully offset the cost savings related to warts associated with the quadrivalent vaccine. Furthermore, a cost-effectiveness analysis shows that, considering regional tariffs, the multiple cohort (12-year-old + 25-year-old women) vaccination strategy with a 90% coverage could prevent 33 cases of cervicocarcinoma and 15 related deaths more than the vaccination of only 12-year-old girls, and thus proves to be cost-effective (11,974 €/QALY)