How to solve financing gap to ensure patient access to patented pharmaceuticals in CEE countries? - the good, the bad, and the ugly ways

• Published in: Expert review of pharmacoeconomics & outcomes research Vol. 19; no. 6; p. 627
• Main Authors: Inotai, András, Kaló, Zoltán
• Format: Journal Article
• Language: English
• Published: England 02.11.2019
• Subjects: Cost-Benefit Analysis; Drug and Narcotic Control; Drug Costs - statistics & numerical data; Economics, Pharmaceutical; European Union; Health Services Accessibility - economics; Humans; Patents as Topic; Pharmaceutical Preparations - economics; Pharmaceutical Preparations - supply & distribution; Reimbursement, Incentive - economics; Risk Sharing, Financial - economics; off-patent medicines; Central and Eastern Europe; inequity; pharmaceutical policy; patient access
• ISSN: 1744-8379
• DOI: 10.1080/14737167.2019.1702524

: There is significant difference in utilization of patented medicines in the EU, as pharmaceuticals at Western European price levels are usually not cost-effective in Central and Eastern European (CEE) countries. The article reviews options to solve the 'financing gap' posed by the challenge of covering patented medicines from more restricted resources in countries with greater unmet medical need. : Hidden volume restrictions to patented pharmaceuticals implemented by payers to facilitate financial sustainability may increase European inequity in patient access. Confidential price discounts and financial risk-sharing agreements improve cost-effectiveness of pharmaceuticals with limited impact on the European floor price. Narrowing the eligible group of patients on the positive drug list can help to target the medicines to patients with potentially greater health benefit whilst reducing the budget impact. Pay-for-performance schemes can improve cost-effectiveness of pharmaceuticals with significant uncertainty or heterogeneity in the magnitude of added therapeutic value. Increased utilization of off-patent pharmaceuticals can increase patient access through re-investing the savings from generic or biosimilar price erosion. : Transparent and sustainable pharmaceutical policies aiming to improve the allocative efficiency of scarce resources should be implemented in CEE to reduce financing gap and improve patient access to high-cost medicines.