Pharmaceutical Pricing, Reimbursement, and Prescribing News in the Fourth Quarter of 2005

This publication has been discontinued on December 21, 2011.

Introduction

Abstract

In This Issue.

In the fourth quarter of 2005, governments in several of the world's leading pharmaceutical markets prepared the ground for major reforms to their drug pricing and reimbursement systems. The United States readied itself for the January 2006 launch of the new Medicare Part D outpatient prescription drug benefit, and a leading pharmacy benefit management company made news with plans to stimulate greater use of generics. The governments of France, Germany, Spain, and Japan all prepared legislation that would introduce major new cost-containment mechanisms into their respective health care systems. The Italian government, however, undertook little in the way of new cost-cutting activity. The U.K. government unveiled measures to expedite access to innovative drugs (especially cancer therapies) and to extend new prescribing powers to qualified nurses and pharmacists. In this report, we review major events in the fourth quarter of 2005 in the pharmaceutical pricing, reimbursement, and prescribing environment in the aforementioned countries and the European Union. We focus on measures that health care payers are using to curb their drug expenditures and to improve patient access to medications. We conclude with an assessment of the outlook and implications for the pharmaceutical industry.

Table of Contents

Overview

United States

• Continued Criticism of Pharmaceutical Price Increases
• Preparations for Medicare Prescription Drug Benefit
  • Employers' Response .
  • Medicare Beneficiaries' Response
  • Pharmaceutical Companies' Response
• Potential Savings from Greater Use of Generics
• Express Scripts Excludes Lipitor from Its Formulary
• Radical Reform of Florida's Medicaid Program

European Union

• Potentially Wider Application of Supplementary Protection Certificates
• Prospects for Pricing Reform

France

• Aggressive Cost-Cutting Program .
• Review of Reimbursement Status of Hundreds of Drugs

Germany

• Increased Pharmaceutical Spending Despite Lower Prices
• Potential for Substantial Savings on Medicines
• Government Plans for Stricter Cost-Containment
  • More-Aggressive Reference Prices
  • Price Freeze .
  • Price Cuts on Off-Patent Medicines and an End to Rebates in Kind
  • Daily Cost of Therapy Limits for Frequently Prescribed Medicines
• Impact of Reference Pricing
• Defeat for Pfizer in Court
• Manufacturer Rebates to Health Insurance Funds

Italy

• Modest Decrease in Pharmaceutical Spending
• Pharmacists Commit to Reducing the Cost of Medicines

Spain

• New Medicines Law Approved by Cabinet
• Call for Greater Transparency in Reimbursement Procedures

United Kingdom

• Patient Action Against Lack of Access to Certain Drugs
• Accelerated NICE Appraisal Process
• Expanded Prescribing Powers for Nurses and Pharmacists

Japan

• Industry Frustration over Proposed Pricing and Reimbursement Reforms
• Increasing Familiarity with Generic Drugs

Outlook and Implications for the Pharmaceutical Industry

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