Search

Introduction: With the introduction of new expensive medicines, traditional pricing schemes based on constructs such as price per pill/vial have been challenged. Potential innovative schemes could be either financial-based or performance-based. Within financial-based schemes the use of price discrimination is an emerging option, which we explore in this assessment.Areas Covered: In the short term the price per indication approach is likely to become more prevalent for high cost, high benefit new pharmaceuticals, such as those emerging in oncology (e.g. new combination immunotherapies). 'Two-Part Pricing' (2PP) is a frequently used payment method in other industries, which consists of an Entry Fee, giving the buyer the right to use the product, and a Usage Price charged every time the product is purchased. Introducing 2PP into biopharma could have cross-stakeholder benefits including broader patient access, and improvement in budget/revenue predictability. A concern however is the potential complexity of the negotiation between manufacturer and payer.Expert Commentary: We believe 'price discrimination' and 2PP in particular can be relevant for some new, expensive specialist medicines. A recommended first step would be to initiate pilots to test to what degree the 2PP approach meets stakeholder objectives and is practical to implement within specialty care. [ABSTRACT FROM AUTHOR]

This paper has two purposes. The first is to examine whether increased medication of inhaled corticosteroids by asthmatic patients is correlated with an improvement in asthma control, measured as a reduction in asthma hospitalizations. The other purpose, if such a relationship can be established, is to analyse the economic consequences. Regional data on asthma hospitalization, i.e. number of bed-days, and sales of anti-asthmatic drugs from 14 regions in Sweden between 1978 and 1989 were used (covering 71% of the Swedish population). The data were analysed in multivariate pooled cross-section, time-series regressions. The variation in bed-days was explained by three variables: the sales of inhaled corticosteroids; total supply of in-patient care; and sales of inhaled bronchodilators, which were used as a proxy for asthma prevalence. The results indicate that sales of inhaled corticosteroids are significantly correlated with decreased hospitalizations for asthma. Assuming that the correlation also reflects a causal relationship, an increase in sales of inhaled corticosteroids by 1 defined daily dose (DDD) per day and 1000 inhabitants gave, on average over the study period, a reduction of 1.7 bed-days for asthma in in-patient care per 1000 inhabitants. [ABSTRACT FROM AUTHOR]