Pricing and Reimbursement Issues in Psychiatry

This publication has been discontinued on December 21, 2011.

Introduction

Abstract

Introduction

Compared with many other disease areas (e.g., cancer, immune diseases), the costs of drug therapy for psychiatric disorders are relatively modest. However, the World Health Organization forecasts that by 2020, depression-just one of a spectrum of psychiatric disorders-will be the second most frequent cause of death and disability in the world and the leading cause in industrialized nations. In anticipation of this surge, payers in the major pharmaceutical markets would like to exercise greater control over the use of psychiatric drugs.

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In just the major pharmaceutical markets, the number of people affl icted with common psychiatric disorders will increase, and spending on drug therapies will grow steadily. How will payers try to curb spending on psychiatric drugs? The prices of generic antidepressants are much higher in Europe than in the United States. What factors are behind this differential? Pharmacy benefits offered by U.S. private insurers tend to be considerably more generous than the coverage provided by Medicare and Medicaid, but cost-containment measures are proliferating. What steps are private insurers taking to control drug expenditures? Medicare Part D offers outpatient drug coverage to all Medicare beneficiaries who choose to enroll. What will be the standard benefi t design of Part D in 2007? The U.S. Medicaid program is a major source of funding for psychiatric drugs-especially atypical antipsychotics. What cost-cutting measures are state Medicaid programs instituting to control drug expenditures? France has the lowest average prices of any of the major pharmaceutical markets for branded antidepressants. Nevertheless, the government would like to reduce spending on this drug class. What steps has the Caisse Nationale de l' Assurance Maladie taken to stimulate France' s relatively immature generics market? How successful have these measures been so far?

Scope

• Drug classes covered: antidepressants, antipsychotics, psychostimulants, hypnotics, sedatives, and anxiolytics.
• Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.
• Price comparisons: comparisons of international pricing of the psychiatric drug classes in this report.
• Reimbursement: overview of the general environment in each market and analysis of factors specific to individual psychiatric drug classes.
• Market outlook: pricing and reimbursement implications for the manufacturers of psychiatric drugs.

Mentioned in This Spectrum Report

Table of Contents

• Executive Summary
• Strategic Considerations
• Stakeholder Implications
• Introduction
• International Price Comparisons of Psychiatric Drugs
• Overview
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics
• Reimbursement Environment
• United States
• General Environment
• Private Insurance
• Medicare
• Sidebar: Patient Assistance Programs-An Important Source of Drug Funding
• Medicaid
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics
• France
• General Environment
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics
• Germany
• General Environment
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics
• Italy
• General Environment
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics
• Spain
• General Environment
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics
• United Kingdom
• General Environment
• Antidepressants
• Antipsychotics
• Psychostimulants
• Hypnotics, Sedatives, and Anxiolytics

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