The Influence of US Drug Price Dynamics on Cost-Effectiveness Analyses of Biologics |
| |
| Affiliation: | 1. Department of Pharmacy Practice, University of Rhode Island College of Pharmacy, Kingston, RI, USA;2. Institute for Clinical and Economic Review, Boston, MA, USA;1. Evidence Synthesis and Decision Modeling, PRECISIONheor, Vancouver, BC, Canada;2. Worldwide Health Economics and Outcomes Research, Bristol Myers Squibb, Uxbridge, England, UK;3. Health Economics and Outcomes Research, Bristol Myers Squibb, Rueil-Malmaison, France;4. Global Biometric Sciences, Bristol Myers Squibb, Boudry, Switzerland;1. Department of Medical Writing and Real World Evidence, Genpro Research Inc, Waltham, MA, USA;2. Department of Medical Writing and Real World Evidence, Genpro Research Pvt Ltd, Thiruvananthapuram, India;1. RTI Health Solutions, Research Triangle Park, NC, USA;2. Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA;1. Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia;2. School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University;3. Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia;4. QIMR Berghofer Medical Research Institute, Herston, QLD, Australia;5. Metro North Mental Health Service, Herston, QLD, Australia;6. Child and Adolescent Mental Health Services Barwon Health, Geelong, VIC, Australia;7. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia;8. Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia;9. Royal Children’s Hospital, Melbourne, VIC, Australia;10. Murdoch Children’s Research Institute, Melbourne, VIC, Australia;11. Child and Youth Mental Health Service, Eastern Health, Melbourne, VIC, Australia;12. School of Population Health, Curtin University, Perth, WA, Australia;13. Caring Futures Institute, Flinders University, Adelaide, SA, Australia;14. Children’s Health, Queensland Hospital and Health Service, University of Queensland, Herston, QLD, Australia;15. Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology, Sydney, NSW, Australia;1. Department of Operating Rooms, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands;2. Nijmegen School of Management, Radboud University, Nijmegen, The Netherlands;3. Faculty of Technology, Policy and Management, Delft, The Netherlands;4. Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands;5. Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands;1. University Hospital of Innsbruck Psychiatry II, Medical University Innsbruck, Innsbruck, Austria;2. Charité – Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychosomatic Medicine, Berlin, Germany;3. School of Psychology, University of Sydney, Camperdown, NSW, Australia;4. School of Population Health, Curtin University, Perth, WA, Australia;5. BC Cancer Research Institute, Vancouver, BC, Canada;6. European Organisation for Research and Treatment of Cancer, Brussels, Belgium;7. Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria;8. Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria |
| |
| Abstract: | ObjectivesThis study aimed to evaluate the influence of drug price dynamics in cost-effectiveness analyses.MethodsWe evaluated scenarios involving typical US drug price increases during the exclusivity period and price decreases after the loss of exclusivity (LOE). Worked examples are presented using the Institute for Clinical and Economic Review’s assessments of tezepelumab for the treatment of severe asthma and targeted immune modulators for rheumatoid arthritis.ResultsTezepelumab case: yearly 2% price increases during the period of exclusivity and a post-LOE price decrease of 25% yielded an incremental cost per quality-adjusted life-year (QALY) gained that increased over the base case from $430 300 to $444 600 (+3.2%). Yearly 2% price increases followed by a steeper post-LOE price reduction of 40% resulted in a cost per QALY gained of $401 400 (6.8% reduction vs the base case). Rheumatoid arthritis case: incorporating post-LOE price reductions for etanercept (intervention) and adalimumab (comparator) ranging from 25% to 40% yielded an incremental cost per QALY of $121 000 and $122 300, respectively (< 3% increase from the base case of $119 200/QALY). Including a 2% yearly price increase during the projected exclusivity periods of both intervention and comparator increased the cost per QALY gained by > 60%.ConclusionTwo biologic treatment cases incorporating price dynamics in cost-effectiveness analyses had varied impacts on the cost-effectiveness ratio depending on the magnitude of pre-LOE price increase and post-LOE price decrease and whether the LOE also affected the comparator. Yearly price increase magnitude during the period of exclusivity, among other factors, may counterbalance the effects of lower post-LOE intervention prices. |
| |
| Keywords: | cost-effectiveness analysis dynamic exclusivity pricing |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
