International variability in the reimbursement of cancer drugs by publically funded drug programs

被引:62
作者
Cheema, P. K. [5 ]
Gavura, S. [2 ]
Migus, M. [3 ]
Godman, B. [4 ]
Yeung, L. [3 ]
Trudeau, M. E. [1 ,2 ,5 ]
机构
[1] Sunnybrook Hlth Sci Ctr, Odette Canc Ctr, Toronto, ON M4N 3M5, Canada
[2] Canc Care Ontario, Toronto, ON, Canada
[3] Deeth Williams Wall LLP, Toronto, ON, Canada
[4] Karolinska Univ Hosp, Div Clin Pharmacol, Stockholm, Sweden
[5] Univ Toronto, Dept Med, Toronto, ON, Canada
关键词
Reimbursement; cancel; drugs; risk-sharing agreements; COST-EFFECTIVENESS; ARRANGEMENTS; DECISIONS; MEDICINES; AUSTRALIA; CANADA; TRENDS;
D O I
10.3747/co.19.946
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose Evaluate inter-country variability in the reimbursement of publically funded cancer drugs, and identify factors such as cost containment measures that may contribute to variability. Methods As of February 28, 2010, licensed indications for 10 cancer drugs (bevacizumab, bortezomib, cetuximab, erlotinib, imatinib, pemetrexed, rituximab, sorafenib, sunitinib, and trastuzumab) were obtained from the drug registries of 6 licensing authorities corresponding to 13 countries or regions: Australia, Canada (Ontario), England, Finland, France, Italy, Germany, Japan, New Zealand, the Netherlands, Scotland, Sweden, and the United States (Medicare Parts B and D). Number of licensed indications reimbursed by public payers and the use of cost containment measures were obtained by survey of health authorities involved in reimbursement and through public documents. Results The 48 identified licensed indications varied between agencies (range: 36-44 indications). Finland, France, Germany, Sweden, and the United States reimbursed the highest percentage of indications (range: 90%-100%). Canada (54%), Australia (46%), Scotland (40%), England (38%), and New Zealand (25%) reimbursed the least. All 5 countries with the lowest rate of reimbursement incorporated a cost-effectiveness analysis into reimbursement decisions and rejected submissions for reimbursement mainly because of lack of cost effectiveness; in New Zealand, lack of cost effectiveness was the second leading cause of rejection after excessive cost. In 9 countries, risk-sharing agreements were used to contain costs. Indications initially not recommended for reimbursement (9 in Australia, 5 in Canada, and 3 in England, New Zealand, and Scotland) were subsequently approved with risk-sharing agreements or special pricing arrangements. Conclusions Reimbursement of publically funded cancer drugs varies globally. The cause is multi factorial.
引用
收藏
页码:E165 / E176
页数:12
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