Christine Leopold1, Steven G Morgan2, Anita K Wagner3. 1. Postdoctoral Fellow, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States. Electronic address: christine_leopold1@hphc.org. 2. Professor and Director, Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC, United States. 3. Associate Professor, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States.
Abstract
BACKGROUND: With the launch of very highly priced therapies and sudden price increases of generics, pressures on health systems have drastically increased. OBJECTIVES: We aimed to elicit opinions of key decision makers responsible for national assessment and funding decisions on their experiences to adapt to these new realities. METHODS/ SETTING: Through interviews with decision makers of pharmaceutical assessment and/or funding agencies, we describe the challenges systems are currently facing, systems' responses and systems' characteristics facilitating or hindering responses to changes and overarching topics for the future. RESULTS: Among the most common challenges are increased funding pressures, increased uncertainty and lack of transparency in decision-making. Systems' responses include utilization management, changing of assessment processes, stakeholder engagement and a focus on outcomes and on coordinated negotiations. Integrated delivery systems, fixed health care budgets and geographic and historical characteristics facilitate or sometimes hinder responses to change. Future policy emphasis lays on expanding data structures, managing the exit of drugs funded early, and implementing processes for communications with patients and the public. CONCLUSIONS: Going forward emphasis has to be given to structured communications with all stakeholders with a specific emphasis on the broader public and patients about financial limits and priority setting in health care.
BACKGROUND: With the launch of very highly priced therapies and sudden price increases of generics, pressures on health systems have drastically increased. OBJECTIVES: We aimed to elicit opinions of key decision makers responsible for national assessment and funding decisions on their experiences to adapt to these new realities. METHODS/ SETTING: Through interviews with decision makers of pharmaceutical assessment and/or funding agencies, we describe the challenges systems are currently facing, systems' responses and systems' characteristics facilitating or hindering responses to changes and overarching topics for the future. RESULTS: Among the most common challenges are increased funding pressures, increased uncertainty and lack of transparency in decision-making. Systems' responses include utilization management, changing of assessment processes, stakeholder engagement and a focus on outcomes and on coordinated negotiations. Integrated delivery systems, fixed health care budgets and geographic and historical characteristics facilitate or sometimes hinder responses to change. Future policy emphasis lays on expanding data structures, managing the exit of drugs funded early, and implementing processes for communications with patients and the public. CONCLUSIONS: Going forward emphasis has to be given to structured communications with all stakeholders with a specific emphasis on the broader public and patients about financial limits and priority setting in health care.
Authors: Damiana da Rocha Vianna Flôres; Alexandre Augusto de Toni Sartori; Julia Borges Antunes; Alessandra Nunes Pinto; Julia Pletsch; Tatiane da Silva Dal Pizzol Journal: Eur J Hosp Pharm Date: 2018-03-22