by Belén Diego at the GIRP conference
MADRID, May 30 (APM) - Pricing considerations should take value into account, but they must also include the cost of R&D, market size, a reward for risk, the period of market exclusivity and budgetary impact, according to the executive director of not-for-profit insurers association AIM.
Speaking in Madrid at the conference of European pharmaceutical wholesalers (GIRP), Mennon Aarnout said he does not share the industry's motto "the higher the value, the higher the price". He said that as important as value is, a fair price would also be based on these additional factors.
He also noted that a discussion about a fair price for healthcare will only be possible when there is transparency on R&D costs, clinical trial data and prices themselves. "The truth is quite often that prices of healthcare products or R&D costs are not disclosed, and this is information we need to know if 'the price is right'", he said.
If the cost of R&D is to be known in order to determine a fair price, Aarnout suggested that research in public or publicly funded institutions, public or charitable subsidies granted to private companies, and R&D tax credits should be taken into account.
Aarnout, whose association represents insurers covering some 200 million European citizens, argued that it is difficult to base pricing on value when there is a lack of consensus regarding the definition of value itself, which is very different not only from one country to the next, but also between patients, payers, clinicians and society as a whole.
Other unresolved questions regarding value-based pricing include separating innovation and value, dealing with the uncertainty of evidence and whether to assess side effects differently for use in chronically or terminally ill patients.
And even if value can be measured, how that value can be reflected in market access and pricing decisions is a different issue, he warned.
Aarnout's speech came in a session about patient-centric approaches to value, "which has turned payers into players" as payment for performance has taken over from fees for services.
"Patient-centered care translates into payment based on the actual outcome for patients, relative to the costs," he said.
This kind of calculation will require more emphasis on health technology assessment protocols, increased measurement of performance and patient-centered financing. It also raises the question of the convenience of bundled payments based on diagnosis-related groups (DRGs).
/bd/clg
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