Patient access schemes in Asia-pacific markets

Current experience and future potential

Christine Y. Lu, Caitlin Lupton, Shana Rakowsky, Zaheer Ud Din Babar, Dennis Ross-Degnan, Anita K. Wagner

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: Patient access (or risk-sharing) schemes are alternative market access agreements between healthcare payers and medical product manufacturers for conditional coverage of promising health technologies. This study aims to identify and characterize patient access schemes to date in the Asia-Pacific region. Methods: We reviewed the literature on patient access schemes over the last two decades using publicly available databases, Internet, and grey literature searches. We extracted key features of each scheme identified, including the drug, clinical indication, stakeholders involved, and details of the scheme. We categorized schemes according to a previously published taxonomy of scheme types and by country. Results: We identified 3 schemes in South Korea, 5 in New Zealand, and 98 in Australia. Most (97.2%; n = 103) schemes focused on pharmaceuticals, few on medical technologies. More than half of the schemes related to treatments for cancer and inflammatory diseases such as rheumatoid arthritis. The majority (77.4%; n =82) involved pricing arrangements. Evidence generation schemes were rarely used. About half (41.8%; n = 41) of schemes in Australia were hybrid by nature, consisting of pricing arrangements with a conditional treatment continuation component. Conclusions: Australia has the most experience with patient access schemes and its experience may provide useful insights for other Asia-Pacific countries. The main targets are pharmaceuticals likely to have high budget impact (due to high per-patient costs and/or large volumes of use), and pharmaceuticals that may be adopted more widely than indicated. With the proliferation of high-cost medicines, the use of schemes may increase to address rising cost pressures, consumer demands, and uncertainties, while attempting to provide patient access to innovative care within finite budgets. Future research is warranted to evaluate the performance of patient access schemes.

Original languageEnglish
Article number6
Pages (from-to)1-12
Number of pages12
JournalJournal of Pharmaceutical Policy and Practice
Volume8
Issue number1
DOIs
Publication statusPublished - 16 Feb 2015
Externally publishedYes

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Costs and Cost Analysis
Budgets
Pharmaceutical Preparations
Literature
Republic of Korea
Biomedical Technology
Second Primary Neoplasms
New Zealand
Internet
Uncertainty
Rheumatoid Arthritis
Databases
Technology
Delivery of Health Care
Pressure
Therapeutics

Cite this

Lu, Christine Y. ; Lupton, Caitlin ; Rakowsky, Shana ; Babar, Zaheer Ud Din ; Ross-Degnan, Dennis ; Wagner, Anita K. / Patient access schemes in Asia-pacific markets : Current experience and future potential. In: Journal of Pharmaceutical Policy and Practice. 2015 ; Vol. 8, No. 1. pp. 1-12.
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abstract = "Objectives: Patient access (or risk-sharing) schemes are alternative market access agreements between healthcare payers and medical product manufacturers for conditional coverage of promising health technologies. This study aims to identify and characterize patient access schemes to date in the Asia-Pacific region. Methods: We reviewed the literature on patient access schemes over the last two decades using publicly available databases, Internet, and grey literature searches. We extracted key features of each scheme identified, including the drug, clinical indication, stakeholders involved, and details of the scheme. We categorized schemes according to a previously published taxonomy of scheme types and by country. Results: We identified 3 schemes in South Korea, 5 in New Zealand, and 98 in Australia. Most (97.2{\%}; n = 103) schemes focused on pharmaceuticals, few on medical technologies. More than half of the schemes related to treatments for cancer and inflammatory diseases such as rheumatoid arthritis. The majority (77.4{\%}; n =82) involved pricing arrangements. Evidence generation schemes were rarely used. About half (41.8{\%}; n = 41) of schemes in Australia were hybrid by nature, consisting of pricing arrangements with a conditional treatment continuation component. Conclusions: Australia has the most experience with patient access schemes and its experience may provide useful insights for other Asia-Pacific countries. The main targets are pharmaceuticals likely to have high budget impact (due to high per-patient costs and/or large volumes of use), and pharmaceuticals that may be adopted more widely than indicated. With the proliferation of high-cost medicines, the use of schemes may increase to address rising cost pressures, consumer demands, and uncertainties, while attempting to provide patient access to innovative care within finite budgets. Future research is warranted to evaluate the performance of patient access schemes.",
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Patient access schemes in Asia-pacific markets : Current experience and future potential. / Lu, Christine Y.; Lupton, Caitlin; Rakowsky, Shana; Babar, Zaheer Ud Din; Ross-Degnan, Dennis; Wagner, Anita K.

In: Journal of Pharmaceutical Policy and Practice, Vol. 8, No. 1, 6, 16.02.2015, p. 1-12.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patient access schemes in Asia-pacific markets

T2 - Current experience and future potential

AU - Lu, Christine Y.

AU - Lupton, Caitlin

AU - Rakowsky, Shana

AU - Babar, Zaheer Ud Din

AU - Ross-Degnan, Dennis

AU - Wagner, Anita K.

PY - 2015/2/16

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N2 - Objectives: Patient access (or risk-sharing) schemes are alternative market access agreements between healthcare payers and medical product manufacturers for conditional coverage of promising health technologies. This study aims to identify and characterize patient access schemes to date in the Asia-Pacific region. Methods: We reviewed the literature on patient access schemes over the last two decades using publicly available databases, Internet, and grey literature searches. We extracted key features of each scheme identified, including the drug, clinical indication, stakeholders involved, and details of the scheme. We categorized schemes according to a previously published taxonomy of scheme types and by country. Results: We identified 3 schemes in South Korea, 5 in New Zealand, and 98 in Australia. Most (97.2%; n = 103) schemes focused on pharmaceuticals, few on medical technologies. More than half of the schemes related to treatments for cancer and inflammatory diseases such as rheumatoid arthritis. The majority (77.4%; n =82) involved pricing arrangements. Evidence generation schemes were rarely used. About half (41.8%; n = 41) of schemes in Australia were hybrid by nature, consisting of pricing arrangements with a conditional treatment continuation component. Conclusions: Australia has the most experience with patient access schemes and its experience may provide useful insights for other Asia-Pacific countries. The main targets are pharmaceuticals likely to have high budget impact (due to high per-patient costs and/or large volumes of use), and pharmaceuticals that may be adopted more widely than indicated. With the proliferation of high-cost medicines, the use of schemes may increase to address rising cost pressures, consumer demands, and uncertainties, while attempting to provide patient access to innovative care within finite budgets. Future research is warranted to evaluate the performance of patient access schemes.

AB - Objectives: Patient access (or risk-sharing) schemes are alternative market access agreements between healthcare payers and medical product manufacturers for conditional coverage of promising health technologies. This study aims to identify and characterize patient access schemes to date in the Asia-Pacific region. Methods: We reviewed the literature on patient access schemes over the last two decades using publicly available databases, Internet, and grey literature searches. We extracted key features of each scheme identified, including the drug, clinical indication, stakeholders involved, and details of the scheme. We categorized schemes according to a previously published taxonomy of scheme types and by country. Results: We identified 3 schemes in South Korea, 5 in New Zealand, and 98 in Australia. Most (97.2%; n = 103) schemes focused on pharmaceuticals, few on medical technologies. More than half of the schemes related to treatments for cancer and inflammatory diseases such as rheumatoid arthritis. The majority (77.4%; n =82) involved pricing arrangements. Evidence generation schemes were rarely used. About half (41.8%; n = 41) of schemes in Australia were hybrid by nature, consisting of pricing arrangements with a conditional treatment continuation component. Conclusions: Australia has the most experience with patient access schemes and its experience may provide useful insights for other Asia-Pacific countries. The main targets are pharmaceuticals likely to have high budget impact (due to high per-patient costs and/or large volumes of use), and pharmaceuticals that may be adopted more widely than indicated. With the proliferation of high-cost medicines, the use of schemes may increase to address rising cost pressures, consumer demands, and uncertainties, while attempting to provide patient access to innovative care within finite budgets. Future research is warranted to evaluate the performance of patient access schemes.

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KW - Conditional coverage

KW - Health technology assessment

KW - High cost medicines

KW - Managed entry

KW - Patient access schemes

KW - Risk sharing

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DO - 10.1186/s40545-014-0019-x

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SN - 2052-3211

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