Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands, and New Zealand
This PDF is a selection from a published volume from the National Bureau of Economic Research Volume Title: Frontiers in Health Policy Research, Volume 7 Volume Author/Editor: David M. Cutler and Alan M. Garber, editors Volume Publisher: MIT Press Volume ISBN: 0-262-03325-9 Volume URL: http://www.nber.org/books/cutl04-1 Conference Date: June 6, 2003 Publication Date: July 2004 Title: Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands, and New Zealand Author: Patricia M. Danzon, Jonathan D. Ketcham URL: http://www.nber.org/chapters/c9868 1 Reference Pricing of Pharmaceuticals for Medicare: Evidence from Germany, the Netherlands, and New Zealand Patricia M. Danzon, University of Pennsylvania, and NBER Jonathan D. Ketcham, University of California, Berkeley, and University of California, San Francisco Executive Summary This paper describes three prototypical systems of therapeutic reference pricing (RI') for pharmaceuticalsGermany, the Netherlands, and New Zealandand examines their effects on the availability of new drugs, reim- bursement levels, manufacturer prices, and out-of-pocket surcharges to patients. RP for pharmaceuticals is not simply analogous to a defined contri- bution approach to subsidizing insurance coverage. Although a major purpose of RI' is to stimulate competition, theory suggests that the achievement of this goal is im]ikely, and this is confirmed by the empirical evidence. Other effects of RI' differ across countries in predictable ways, reflecting each country's sys- tem design and other cost-control policies. New Zealand's RP system has reduced reimbursement and limited the availability of new drugs, particularly more expensive drugs. Compared to these three countries,if RP were applied in the United States, it would likely have a more negative effect on prices of on- patent products because of the more competitive U.S.
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