The system that allows patients rapid access to expensive new treatments lacks transparency and penalises small and low-income countries unable to negotiate lower prices with pharmaceutical manufacturers. the authors of this essay on market-access agreements for anti-cancer drugs, say that while the underlying strategy is to help reduce the likelihood of health systems paying for treatments that turn out not to be cost-effective, the agreements can also be seen as an opportunistic way for pharmaceutical manufacturers to keep official prices high.
The authors conducted a comparative analysis of market-access agreements in oncology in the English and Italian health systems. “The emotive nature of cancer makes it difficult for health agencies to resist calls for reimbursement of even extremely expensive drugs with marginal efficacy,” said Dr Garattini. “While performance-based schemes are not without political appeal, they contribute little to robust clinical assessment in practice. Simple financial-based contracts seem more efficient as a means for health services to reduce outlay on costly anti-cancer drugs and achieve access for patients.”
Essay: Katelijne van de Vooren,
Alessandro Curto, Nick Freemantle, and Livio Garattini
Market-access agreements for anti-cancer drugs J R Soc Med 0141076814559626, first published on December 8, 2014 doi:10.1177/0141076814559626