Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

被引：98

作者：

Godman, Brian ^{[1
,2
,3
]}

Malmstrom, Rickard E. ^{[4
]}

Diogene, Eduardo ^{[5
]}

Gray, Andy ^{[6
]}

Jayathissa, Sisira ^{[7
]}

Timoney, Angela ^{[8
,9
]}

Acurcio, Francisco ^{[10
,11
]}

Alkan, Ali ^{[12
]}

Brzezinska, Anna ^{[13
]}

Bucsics, Anna ^{[14
]}

Campbell, Stephen M. ^{[15
,16
]}

Czeczot, Jadwiga ^{[12
]}

de Bruyn, Winnie ^{[17
]}

Eriksson, Irene ^{[18
]}

Yusof, Faridah Aryani Md ^{[19
]}

Finlayson, Alexander E. ^{[20
,21
]}

Furst, Jurij ^{[22
]}

Garuoliene, Kristina ^{[23
,24
]}

Guerra Junior, Augusto ^{[25
]}

Gulbinovic, Jolanta ^{[26
,27
]}

Jan, Saira ^{[28
,29
]}

Joppi, Roberta ^{[30
]}

Kalaba, Marija ^{[31
]}

Magnisson, Einar ^{[32
]}

McCullagh, Laura ^{[33
]}

Miikkulainen, Kaisa ^{[34
]}

Ofierska-Sujkowska, Gabriela ^{[35
]}

Pedersen, Hanne Bak ^{[36
]}

Selke, Gisbert ^{[37
]}

Sermet, Catherine ^{[38
]}

Spillane, Susan ^{[39
]}

Supian, Azuwana ^{[40
]}

Truter, Ilse ^{[41
]}

Vlahovic-Palcevski, Vera ^{[42
]}

Vien, Low Ee ^{[40
]}

Vural, Elif H. ^{[43
]}

Wale, Janet

Wladysiuk, Magdalene ^{[44
]}

Zeng, Wenjie ^{[45
]}

Gustafsson, Lars L. ^{[1
]}

机构：

[1] Karolinska Univ, Huddinge Hosp, Karolinska Inst, Dept Lab Med,Div Clin Pharmacol, Stockholm, Sweden

[2] Univ Strathclyde, Strathclyde Inst Pharm & Biomed Sci, Glasgow, Lanark, Scotland

[3] Univ Liverpool, Sch Management, Liverpool Hlth Econ Ctr, Liverpool L69 3BX, Merseyside, England

[4] Karolinska Univ, Hosp Solna, Karolinska Inst, Dept Med,Clin Pharmacol Unit, Stockholm, Sweden

[5] Vall Hebron Univ Hosp, Fdn Inst Catala Farmacol, Barcelona 08035, Spain

[6] Univ KwaZulu Natal, Sch Hlth Sci, Discipline Pharmaceut Sci, Div Pharmacol, ZA-4013 Congella, South Africa

[7] Hutt Valley DHB, Dept Med, Wellington, New Zealand

[8] Univ Strathclyde, Strathclyde Inst Pharm & Biomed Sci, Glasgow, Lanark, Scotland

[9] NHS Lothian Director Pharm, Edinburgh, Midlothian, Scotland

[10] Fed Univ Minas Gerais UFMG, Coll Med, BR-30130100 Belo Horizonte, MG, Brazil

[11] Fed Univ Minas Gerais UFMG, Coll Pharm, BR-30130100 Belo Horizonte, MG, Brazil

[12] Minist Hlth Turkey, Turkish Med & Med Devices Agcy, Dept Rational Drug Use, Ankara, Turkey

[13] Agcy Hlth Technol Assessment, Warsaw, Poland

[14] Univ Vienna, Vienna, Austria

[15] Univ Manchester, Inst Populat Hlth, Ctr Primary Care, Manchester M13 9PL, Lancs, England

[16] Univ Manchester, Inst Populat Hlth, NIHR Greater Manchester Primary Care Patient Safe, Manchester M13 9PL, Lancs, England

[17] Univ Utrecht, Dept Pharmaceut Sci, Utrecht, Netherlands

[18] Stockholm Cty Council, Publ Healthcare Serv Comm Adm, Stockholm, Sweden

[19] Minist Hlth, Pharmaceut Serv Div, Kuantan, Malaysia

[20] Univ Oxford, Green Templeton Coll, Nuffield Dept Primary Care Hlth Sci, Oxford OX2 6HG, England

[21] Univ Oxford, Acad Clin Fellow, Oxford OX2 6HG, England

[22] Hlth Insurance Inst, Ljubljana, Slovenia

[23] Vilnius Univ, Fac Med, Dept Pathol Forens Med & Pharmacol, Vilnius, Lithuania

[24] Natl Hlth Insurance, Med Reimbursement Dept, Vilnius, Lithuania

[25] Fed Univ Minas Gerais UFMG, Coll Pharm, BR-31270901 Belo Horizonte, MG, Brazil

[26] Vilnius Univ, Fac Med, Dept Pathol Forens Med & Pharmacol, Vilnius, Lithuania

[27] State Med Control Agcy, Vilnius, Lithuania

[28] Rutgers State Univ, Piscataway, NJ USA

[29] Horizon Blue Cross Blue Shield New Jersey, Newark, NJ USA

[30] Azienda Sanitaria Locale Verona, Pharmaceut Drug Dept, Verona, Italy

[31] Republ Inst Hlth Insurance, Belgrade, Serbia

[32] Minist Hlth, Dept Hlth Serv, Reykjavik, Iceland

[33] St James Hosp, Natl Ctr Pharmacoecon, Dublin 8, Ireland

[34] Karolinska Inst, Med Management Ctr, Dept Learning Informat Management & Eth, Stockholm, Sweden

[35] Agcy Hlth Technol Assessment, Warsaw, Poland

[36] WHO, Reg Off Europe, Hlth Technol & Pharmaceut, Div Hlth Syst & Publ Hlth, DK-2100 Copenhagen, Denmark

[37] Wissenschaftliches Inst AOK WIdO, Berlin, Germany

[38] IRDES, F-75018 Paris, France

[39] Univ Dublin Trinity Coll, Dept Pharmacol & Therapeut, Dublin 2, Ireland

[40] Minist Hlth, Pharmaceut Serv Div, Kuantan, Malaysia

[41] NMMU, DURU, Dept Pharm, ZA-6031 Port Elizabeth, South Africa

[42] Univ Hosp Rijeka, Clin Pharmacol Unit, Rijeka 51000, Croatia

[43] Minist Hlth Turkey, Turkish Med & Med Devices Agcy, Dept Econ Evaluat, Ankara, Turkey

[44] HTA Consulting, Krakow, Poland

[45] Chongqing Jiaotong Univ, Sch Management, Chongqing 400074, Peoples R China

来源：

EXPERT REVIEW OF CLINICAL PHARMACOLOGY | 2015年 / 8卷 / 01期

关键词：

clinical pharmacology; critical drug evaluation; dabigatran; differential pricing; ivacaftor; managed entry agreements; new models; rational use of medicines; sofosbuvir; trastuzumab emtansine; ORPHAN DRUGS; PRESCRIBING EFFICIENCY; ATRIAL-FIBRILLATION; COST-EFFECTIVENESS; UNITED-STATES; HEPATITIS-C; PHARMACEUTICAL COMPANIES; INSTITUTIONAL CORRUPTION; TECHNOLOGY-ASSESSMENT; RHEUMATOID-ARTHRITIS;

D O I：

10.1586/17512433.2015.990380

中图分类号：

R9 [药学];

学科分类号：

1007 ;

摘要：

Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. A number of issues and challenges were identified from the case histories. These included the low number of new medicines seen as innovative alongside increasing requested prices for their reimbursement, especially for oncology, orphan diseases, diabetes and HCV. Proposed models center on the three pillars of pre-, peri- and post-launch including critical drug evaluation, as well as multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure. In conclusion, the proposed models involving all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.

引用

页码：77 / 94

页数：18

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