E J van de Wetering1, Job van Exel2, Werner B F Brouwer1. 1. Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. 2. Erasmus School of Economics, Erasmus University Rotterdam, The Netherlands. Electronic address: vanexel@bmg.eur.nl.
Abstract
BACKGROUND: Conditional reimbursement of new health technologies is increasingly considered as a useful policy instrument. It allows gathering more robust evidence regarding effectiveness and cost-effectiveness of new technologies without delaying market access. Nevertheless, the literature suggests that ending reimbursement and provision of a technology when it proves not to be effective or cost-effective in practice may be difficult. OBJECTIVES: To investigate how policymakers and the general public in the Netherlands value removing a previously reimbursed treatment from the basic benefits package relative to not including a new treatment. METHODS: To investigate this issue, we used discrete-choice experiments. Mixed multinomial logit models were used to analyze the data. Compensating variation values and changes in probability of acceptance were calculated for withdrawal of reimbursement. RESULTS: The results show that, ceteris paribus, both the general public (n = 1169) and policymakers (n = 90) prefer a treatment that is presently reimbursed over one that is presently not yet reimbursed. CONCLUSIONS: Apparently, ending reimbursement is more difficult than not starting reimbursement in the first place, both for policymakers and for the public. Loss aversion is one of the possible explanations for this result. Policymakers in health care need to be aware of this effect before engaging in conditional reimbursement schemes.
BACKGROUND: Conditional reimbursement of new health technologies is increasingly considered as a useful policy instrument. It allows gathering more robust evidence regarding effectiveness and cost-effectiveness of new technologies without delaying market access. Nevertheless, the literature suggests that ending reimbursement and provision of a technology when it proves not to be effective or cost-effective in practice may be difficult. OBJECTIVES: To investigate how policymakers and the general public in the Netherlands value removing a previously reimbursed treatment from the basic benefits package relative to not including a new treatment. METHODS: To investigate this issue, we used discrete-choice experiments. Mixed multinomial logit models were used to analyze the data. Compensating variation values and changes in probability of acceptance were calculated for withdrawal of reimbursement. RESULTS: The results show that, ceteris paribus, both the general public (n = 1169) and policymakers (n = 90) prefer a treatment that is presently reimbursed over one that is presently not yet reimbursed. CONCLUSIONS: Apparently, ending reimbursement is more difficult than not starting reimbursement in the first place, both for policymakers and for the public. Loss aversion is one of the possible explanations for this result. Policymakers in health care need to be aware of this effect before engaging in conditional reimbursement schemes.
Authors: Adriënne H Rotteveel; Mattijs S Lambooij; Nicolaas P A Zuithoff; Job van Exel; Karel G M Moons; G Ardine de Wit Journal: Pharmacoeconomics Date: 2020-05 Impact factor: 4.981
Authors: Rositsa Koleva-Kolarova; James Buchanan; Heleen Vellekoop; Simone Huygens; Matthijs Versteegh; Maureen Rutten-van Mölken; László Szilberhorn; Tamás Zelei; Balázs Nagy; Sarah Wordsworth; Apostolos Tsiachristas Journal: Appl Health Econ Health Policy Date: 2022-04-04 Impact factor: 3.686
Authors: Adriënne H Rotteveel; Mattijs S Lambooij; Joline J A van de Rijt; Job van Exel; Karel G M Moons; G Ardine de Wit Journal: BMC Health Serv Res Date: 2021-04-01 Impact factor: 2.655
Authors: Carlo Federici; Vivian Reckers-Droog; Oriana Ciani; Florian Dams; Bogdan Grigore; Zoltán Kaló; Sándor Kovács; Kosta Shatrov; Werner Brouwer; Michael Drummond Journal: Eur J Health Econ Date: 2021-06-12