New analysis on external reference pricing shows negative impact on drug availability

Kanavos et al. just published another analysis on external reference pricing (ERP). ERP is widely applied by many payers across the world and also delivers short term cost savings for health care systems. Conclusions by Kanavos et al. are as follows: “ERP has not regulated prices efficiently and has unintended consequences that reduce the benefits arising from it. If ERP is carefully designed with minimal price revisions, prudent selection of basket size and countries, and consideration of transaction prices, it could be a more effective mechanism enhancing welfare, equitable access to medicines within countries and help promote industry innovation.”

The full article is available in the European Journal of Health Economics.

MArS has experience in pricing research and strategy as well as in price negotiations and can hence assess the ERP impact on the D-A-CH countries in detail.

Secondary HE analysis on the EFFORT study published!

Existing guidelines support the importance of nutritional interventions for medical inpatients at malnutrition risk to alleviate the impact of malnutrition on outcomes. MArS in conjunction with the investigators of the EFFORT – a pragmatic, investigator-initiated, open-label, multicenter Swiss trial have developed and executed a probabilistic health economic analysis. Our evaluation demonstrates that in-hospital nutritional support for medical inpatients is a highly cost-effective intervention in Switzerland to reduce risks for ICU admissions and hospital-associated complications, while improving patient survival.

The full article is available on the website of the Journal of Clinical Nutrition

MArS has a strong background in health economics, the related data analytics, medical writing and communication with payers. We have developed various health economic analyses in the last years which lead to over 35 manuscripts in scientific journals and more than 150 presentations at conferences.

Communication with cost carriers

Incidence of acquired thrombotic thrombocytopenic purpura in Germany

Acquired thrombotic thrombocytopenic Purpura (aTTP) is a life-threatening ultra-orphan disease with a reported annual incidence between 1.5 and 6.0 cases per million in Europe and mainly affecting otherwise young and healthy adults aged 40 years on average. The goal of this study was to assess the incidence of aTTP in Germany. A systematic review was performed to determine the published evidence on the aTTP epidemiology in Germany. To obtain additional evidence on the proportion of aTTP cases within the national Thrombotic Microangiopathy (TMA) population a hospital-level study was performed, using a retrospective data collection approach. Diagnosis of aTTP was confirmed if ADAMTS13 level were < 10% and/or the medical records explicitly mentioned aTTP diagnosis. The aggregated hospital data were then projected to the national level using logistic regression techniques.
The determined annual incidence of newly diagnosed aTTP cases and the overall annual incidence of aTTP episodes in Germany confirm the ultra-orphan character of aTTP.

Download the full article here:

Miesbach, W., Menne, J., Bommer, M. et al. Incidence of acquired thrombotic thrombocytopenic purpura in Germany: a hospital level study. Orphanet J Rare Dis 14, 260 (2019) doi:10.1186/s13023-019-1240-0

Risk share agreements and application in global reimbursement decisions

Which risk share agreements are available and are those applied in global reimbursement decisions?

Risk Share Agreements (RSAs) are defined as agreements between a payer and a manufacturer where the price level is related to the actual future performance of the product. In the last years RSAs were introduced and applied in various jurisdictions. RSAs in Australia, Canada, Italy, Spain, UK and the US were systematically searched for. They were clustered into the type of RSA per country and compared to each other.

Download the poster including all results: Walzer_et_al._Risk_Share_Agreements_ISPOR_2015

A systematic comparison of AMNOG decisions

On January 1st 2011 Act on the Reform of the Market for Medicinal Products (AMNOG) came into force in Germany. The aim of AMNOG is to curb the rapidly rising expenditure for pharmaceutical products by the statutory health insurance funds.

Since the introduction of AMNOG, more than 100 IQWiG recommendations and G-BA decisions on the early benefit assessment have been published. In various assessments, the IQWiG recommendation and the related G-BA decision differed in terms of decision argumentation and actual result.

In this study, these differences were systematically analyzed in order to draw conclusions for future proceedings and optimization of the process.

Download the poster: Vollmer_et_al._IQWiG_vs_G-BA_ISPOR_2015