Home > Past Briefings > Briefing Detail Page
 

Briefing Detail Page

Change Text Size:   Smaller Text Size   Larger Text Size   Default Text Size    

Pharmaceutical Policy and Pricing: Are Other Countries Getting Greater Value?


Monday, November 07, 2011

Spending on prescription drugs in the U.S. rose at a faster clip in 2009 than spending for hospital and physician care, a trend that is expected to continue through 2020. By some estimates, prescription drugs account for 15 cents of every health care dollar spent. Thus, federal and state budget cutters – as well as private health plans and hospitals – have a keen interest in restraining drug costs.

The desire to get a handle on drug spending is a focus in other countries as well. What are some strategies used in other countries to control pharmaceutical spending? How is comparative effectiveness research used in making drug coverage decisions? What is the impact of intellectual property law, and what happens when“blockbuster drugs” go off- patent and generics become available? How are value-based models being used by insurers and others to influence pharmaceutical utilization and health outcomes? How do the public and private sectors in the United States seek to contain pharmaceutical spending?

To address these and related questions, the Alliance for Health Reform and The Commonwealth Fund are sponsored a November 7 luncheon briefing. Panelists were: Sir Andrew Dillon, CEO of the National Institute for Health and Clinical Excellence (NICE) in England; Rainer Hess, chairman of Gemeinsamer Bundesausschuss/Federal Joint Committee in Germany; Jean-Luc Harousseau, M.D., chair haute of the Authorité de Santé (HAS)/ National Authority for Health in France; and Ian Spatz of Manatt, Phelps & Phillips, LLP, and Manatt Health Solutions, U.S. Ed Howard of the Alliance and Robin Osborn of Commonwealth moderated. This briefing shed light on how the U.K., Germany and France set national pharmaceutical policies and what lessons learned in those countries may be applicable to the United States.

Speakers

 Robin Osborn, The Commonwealth Fund, Moderator
 Sir Andrew Dillon, National Institute for Health and Clinical Excellence, Speaker
 Rainer Hess, Federal Joint Committee, Speaker
 Jean-Luc Harousseau, National Authority for Health in France, Speaker
 Ian Spatz, Manatt, Phelps & Phillips, LLP, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Transcript (Adobe Acrobat PDF), 11/7/2011
Event Summary: Event Summary (Adobe Acrobat PDF), 11/7/2011
Full Webcast/Podcast: Pharmaceutical Policy and Pricing: Are Other Countries Getting Greater Value?

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Spatz Presentation (PowerPoint), 11/7/2011
Hess Presentation (PowerPoint), 11/7/2011
Dillon Presentation (PowerPoint), 11/7/2011
Harousseau Presentation (PowerPoint), 11/7/2011

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Materials List (Adobe Acrobat PDF), Alliance for Health Reform, 11/7/2011
Source List (Adobe Acrobat PDF), Alliance for Health Reform, 11/7/2011
Agenda (Adobe Acrobat PDF), Alliance for Health Reform, 11/7/2011
Speaker Bios (Adobe Acrobat PDF), Alliance for Health Reform, 11/7/2011
Event Summary (Adobe Acrobat PDF), , 11/7/2011

Offsite Materials (briefing documents saved on other websites)

U.S. drug spending slows; hits $307 bln in 2010: report, Reuters, 4/19/2011
- Berkrot, Bill
Seniors Feeling the Squeeze: Rising Drug Prices and the Part D Program, American Enterprise Institute, 3/17/2010
- Calfee, John E.
The World Medicines Situation 2011, World Health Organization, 1/1/2011
- Lu, Ye, et al.
At Pitney Bowes, Value-Based Insurance Design Cut Copayments and Increased Drug Adherence, The Commonwealth Fund, 11/2/2010
- Choudhry, Niteesh K., et al.
US Pharmaceutical Policy In A Global Marketplace (Adobe Acrobat PDF),Health Affairs, 12/16/2008
- Lakdawalla, Darius N., et al.
Comparative Effectiveness Review Within the U.K.’s National Institute for Health and Clinical Experience (Adobe Acrobat PDF),The Commonwealth Fund, 7/1/2009
- Chalkidou, Kalipso
Projecting future drug expenditures – 2009, American Journal of Health-System Pharmacy, 2/1/2009
- Hoffman, James M., et al.
Drug program saves state millions – but more can be done, The Olympian, 11/1/2011
Ending drug companies’ pay-for-delay deals, The Washington Post, 10/24/2011
Descriptions of Health Care Systems: England, France, and Germany, The Commonwealth Fund, 12/31/2011
- Thomson, Sarah
Multinational Comparisons of Health Systems Data, 2011, The Commonwealth Fund, 12/31/2011
- Squires, David
Prescription Drug Accessibility and Affordability in the United States and Abroad (Adobe Acrobat PDF),The Commonwealth Fund, 6/1/2010
- Morgan, Steve and Jae Kennedy
National Authority for Health: France, The Commonwealth Fund, 7/31/2009
- Rochaix, Lise and Bertrand Xerri
Institute for Quality and Efficiency in Health Care: Germany (Adobe Acrobat PDF),The Commonwealth Fund, 7/1/2009
- Nasser, Mona and Peter Sawicki
The National Institute for Health and Clinical Excellence (NICE), 2011, The National Institute for Health and Clinical Excellence, 12/31/2011
- Rawlins, Michael
National Authority for Health: France, The Commonwealth Fund, 7/1/2009
Prescription Drug Trends (Adobe Acrobat PDF),Kaiser Family Foundation, 5/31/2011
Lower-Than-Expected Medicare Drug Costs Reflect Decline in Overall Drug Spending and Lower Enrollment, Not Private Plans, Center on Budget and Policy Priorities, 5/6/2011
- Park, Edwin
Consumer groups: Obama more generous to Big Pharma in trade talks, Healthwatch, 10/24/2011
- Pecquet, Julian

Photos

Sir Andrew Dillon of the UK's National Institute for Health and Clinical Excellence describes how NICE evaluates drugs and determines their cost effectiveness. From the Nov. 7 briefing cosponsored by The Commonwealth Fund. (11 min.)

 


Sister Carol Keehan on Health Law Enrollment Challenges this Year


Video 3:00

A new Alliance for Health Reform video features Sister Carol Keehan of the Catholic Health Association of the United States addressing the challenges of quickly enrolling millions of Americans for health insurance this fall. Open season begins October 1 of this year, yet she says that up to 85 percent of those who will be newly eligible for Medicaid or for subsidies to buy private insurance in state-based exchanges don't know it.  FULL TRANSCRIPT

Read More 


Jonathan Blum on CMS Efforts to Keep Medicare Spending Growth Down


Video (2:54)

Jonathan Blum, acting principal deputy administrator and director of the Center for Medicare at the Centers for Medicare and Medicaid Services (CMS), addresses the slower growth of Medicare spending over the last few years, and what his agency is doing to try and continue the trend. “There are promising signs that this strategy to change the payment system, to change the payment models, to focus on waste and abuse, is paying off," he said. "We are taking a whole new approach to addressing fraud in the program. Much more data resources, much more on the ground reaction. We have seen dramatic spending declines in areas of spending, such as home health and durable medical supplies that historically fueled lots of the fraud.”  FULL TRANSCRIPT

Read More 

Updated Toolkit -- The Sustainable Growth Rate: Seeking a ‘Doc Fix’ at the Edge of a Fiscal Cliff


A new Alliance toolkit tells you what you need to know about the current policy debate about the $138 billion Medicare physician payment problem – the "doc fix." The public is keeping a close eye on federal budget deficit reduction efforts this year, including potential automatic spending cuts initially mandated by the Budget Control Act of 2011. Yet one component of the debate has been largely ignored - the Sustainable Growth Rate (SGR). Indeed, because of the SGR, physicians in January 2013 faced a 26.5 percent cut in Medicare reimbursement rates. Last-minute congressional intervention delayed the cut until January 2014 as part of the American Taxpayer Relief Act of 2012. Without intervention, physicians will receive a 25 percent reimbursement cut in January 2014. At the same time, according to the most recent Congressional Budget Office (CBO) estimates, if Congress and the president agree to permanently eliminate the SGR, the deficit will grow by another $ 138 billion over 10 years. The cost of repealing the SGR has fallen significantly since last year, spiking a new interest in permanently fixing the problem.

To download, click here.


Read More 

Illinios Health Law Implementation: Race to the Starting Line


Health care experts recently kicked off a series of briefings for reporters addressing complex issues that states face leading up to major 2014 health law changes. Illinois will have a federal partnership insurance exchange next year, but may take more control after that, Deputy Gov. Cristal Thomas said at the first briefing in Chicago. Georgetown University insurance expert Sabrina Corlette, hospital leader David DiLoreto and journalist Bruce Japsen also spoke at the briefing, held Dec. 12 at Columbia College, and sponsored by the Association of Health Care Journalists, the Alliance for Health Reform and the Robert Wood Johnson Foundation.

Read More


Douglas Holtz-Eakin: Health Care Spending Lull Only Temporary


Video (3:11)

A new Alliance for Health Reform video features Douglas Holtz-Eakin of the American Action Forum, and a former director of the Congressional Budget Office, arguing that recent slower spending growth in health care won’t continue.

"We also saw a slowdown in the mid-90s, and we all declared victory and it came right back. I think next year we’ll see a noticeable uptick. There will be lots of new people entering the insurance markets because of the exchanges and the subsidies that come along with them, and those subsidies are very generous. … These are an invitation for people to get coverage and to buy more health care. I think that’ll place a lot of pressure on spending."

FULL TRANSCRIPT

Read More 


Uwe Reinhardt Questions Bundled Payment Savings Prospects


Video (2:58)

A new Alliance for Health Reform video features Princeton’s Uwe Reinhardt questioning whether bundling payments for medical services might actually lead to higher – not lower – costs.

"The ACO's, the accountable care organizations, could create local monopolies that could dictate to you what that bundled price would be, and some of us fear that bundled prices might be even more than what the fee-for-service for that bundle would be today. … You really should align all the payers and say, 'Let us jointly negotiate with the ACOs what those bundles should be so that they cannot divide and rule and sort of make us on the buy side weak.'"

FULL TRANSCRIPT

Read More 

Copyright 1997-2013 Alliance for Health Reform
1444 Eye Street, NW, Suite 910 Washington, DC 20005-6573      202-789-2300      202-789-2233 fax      info@allhealth.org      Sitemap