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Decision Making in Healthcare

Week 4 Diss Feedback DDHA 8600 Hi Tiffany, The WHO defines internal reference pricing as the practice of using the price of identical medicines or similar products or even with therapeutic equivalent treatment in a country to derive a benchmark or reference price from setting or negotiating the price or reimbursement of the product in each country. One study found that reference pricing may increase the use of reference drugs while reducing the use of more expensive drugs requiring patient cost-sharing (Erten et al., 2012). Reference Erten, M., Stuart, B., Davidoff, A., Shoemaker, J., Bryant-Comstock, L., & Shenolikar, R. (2012). How Does Drug Treatment for Diabetes Compare between Medicare Advantage Prescription Drug Plans (MAPDs) and Stand-Alone Prescription Drug Plans (PDPs)?. Health Services Research, 48(3), 1057-1075. doi: 10.1111/1475. 6773.12016 https://bipartisanpolicy.org/wp-content/uploads/2019/10/Examining-Two-Approaches-to-U.S.-Drug- Pricing-1.pdf Hi Trevor, It seems we both are in the Cancer Center world! The financial sustainability of cancer services as part of national health systems is a major challenge; 1 oncology consumes up to 30% of total hospital expenditure and the amount spent on expensive cancer drugs is rising fast. 2 In view of the pipeline of new drugs, these costs are likely to continue to grow. 3 Apart from the risk of unequal access between European countries, burdening health systems with fast-growing costs for these drugs means that the sustainability of cancer care could be compromised (van Harten, Wind, de Paoli, Saghatchian & Oberst, 2016). One study found that beneficiaries with higher out-of-pockel costs for the more expensive oral cancer drugs were more likely to discontinue or delay drug therapy (Kaisaeng, Harpe & Carroll, 2014). Reference Kaisaeng, N., Harpe, S., & Carroll, N. (2014). Out-of-Pocket Costs and Oral Cancer Medication Discontinuation in the Elderly. Journal Of Managed Care Pharmacy, 20(7), 669-675. doi: 10.18553/jmcp.2014.20.7.669 van Harten, W., Wind, A., de Paoli, P., Saghatchian, M., & Oberst, S. (2016). Actual costs of cancer drugs in 15 European countries. The Lancet Oncology, 17(1), 18-20. doi: 10.1016/s1470-2045(15)00486-6 Hi,XXX In general, evidence suggests that external reference pricing is most impactful for determining the maximum price of drugs without generic or therapeutic competition. Implementing any external reference pricing scheme would require building infrastructure and developing the capacity to collect and update comparable data from various countries. using external reference pricing for a subset of Medicare Part B or D single-source brand- name drugs or biologics that are relatively expensive and face limited to no competition (Keliddar, Mosadeghrad & Jafari-Sirizi, 2017). Implementing any external reference pricing scheme would require building an infrastructure to collect and update comparable data from various countries. Reference Keliddar, I., Mosadeghrad, A., & Jafari-Sirizi, M. (2017). Rationing in health systems: A critical review. Medical Journal Of The Islamic Republic Of Iran, 31(1), 271-277. doi: 10.14196/mjiri.31.47