How do different countries negotiate drug prices?

This question is particularly relevant with the passage of the Inflation Reduction Act (IRA) and the requirement that CMS negotiate a ‘maximum fair price’ for drugs with the biggest impact on Medicare’s bottom line. A Health Affairs Forefront paper by Lin et al. (2023) compares how drug price negotiation differs between Canada, France, Germany and…

Why does the UK pay less for medicines?

According to the OECD, In 2021 the U.S. spent $1,432/capita on pharmaceuticals compared to only $517/per capita in the UK. The UK’s figure was slightly higher that Poland and Norway, but less than Latvia, the Slovak Republic, Portugal and Romania. How does the UK spend so little on drugs? Many people focus on the efforts…

Health impact of increasing access to physicians

Out recently is an interesting AEA paper by Okeke 2023, who examines a policy experiment by the Nigerian government that aimed determine whether expand access to physicians improved health outcomes. In this experiment, some communities were randomly selected to receive a new doctor. These doctors were posted to the local public health center. Prior to…

Coverage with evidence development for medical devices in Central and Eastern Europe

The value of medical devices caries with it less certainty than pharmaceuticals for a variety of reasons.  As described in Kovács et al. (2022) medical devices: often have multiple applications, frequently, undergo product modifications and during their product lifecycle, multiple incremental technological innovations take place affecting both clinical and economic consequences of their adoption into…

Adding the patient perspective to health technology assessment

Health technology assessments (HTAs) aim to measure the cost effectiveness of a given treatment or set of treatments for a specific patient populations.  Often, these assessments are conducted from the point of view of the payer–either a national health system or the individual insurer perspective.  This payer focused perspective can often focus largely on treatment costs rather…

Health Care in Malaysia

Malaysia is a middle income country (GDP per capita $26,600, about half of U.S. income levels) of 30.5 million people (about the population of New York and Ohio combined).  Life expectancy is 74.75 years, just 5 years below the U.S.  Health spending in Mayalsia is only 4% of GDP (compared to 17% of GDP in…

CER Around the World

Both the stimulus bill (i.e., The American Recovery and Reinvestment Act of 2009 [ARRA]) and Obamacare (the Affordable Care Act [ACA]) contain provisions to increase funding for compariative effectiveness research (CER).  According to a Deloitte Issue Brief, ARRA provided the foundation for the ACA’s newly mandated and immediately effective CER entity, the Patient-Centered Outcomes Research Institute…