Yes, when you put it like that it a
value-based pricing system might actively discourage innovation: new drugs with
little or no evidence of their effectiveness will probably not be regarded as
useful by customers and so will be bought at a very low price. Pharmaceutical
companies would have to have a great deal of faith in their ability to create
useful drugs and then be willing to take a long term gamble that they will
establish themselves as the best in the minds of their customers.
From:
Evidence based health (EBH) [mailto:
Sent: 24 May 2010 13:52
To:
Subject: Re: Government and NICE:
Myth busting
Love this thread
I don´t know in the
I also, like
Best wishes
On Mon, May 24, 2010 at 7:15 AM,
From what I understand about value-based pricing (and that’s
not a lot so please correct me if I’m wrong) then this will mean that
what the customer considers to be the best drugs will be the most expensive.
The idea, I guess, is to incentivise the pharmaceutical industry to create
drugs that the customer (medical professionals) regards as highly useful as
they will then be paid a high price for them. Sounds like a good idea, though
one obvious consequence is that (without being too cynical) that the
pharmaceutical industry will worry less about actual innovation than convincing
the customers (through their previously mentioned huge marketing budgets) that
their drugs are the best and should have the highest price. That could
potentially lead to even less money for R&D as pharmaceutical companies see
that profits are determined more by the regard in which their drugs are held
rather than (the admittedly related) usefulness of those drugs. I guess it
could go either way depending on how objective the customers can be in ignoring
the marketing and focusing on the evidence.
From: Evidence based health
(EBH) [mailto:[log in to unmask]] On Behalf Of Underhill Jonathan
Sent: 24 May 2010 11:50
To: [log in to unmask]
Subject: Re: Government and NICE:
Myth busting
Ash wrote:
>>>>
While I
fully agree with most of what you have written, there is, in my
opinion, a need to debunk a few myths, especially within the context of
this important email trail.
<<<<<
Great thread!
I think most us would all agree that we need a
profitable pharmaceutical industry to invest in good, robust R&D to drive
the innovation of medicines and patient care.
The key is how to achieve this balance –
driving innovation whilst curbing the worst excesses of the commercial side of
this (usually around marketing and sales) that often provide the stories Ash
illustrates (and there are many, many others – see nofreelunch)
Having read the OFT report when it came out and
also reflecting now on what it said wrt value-based pricing, the notion of the
NHS (or other heathcare system) incentivising and rewarding those medicines
that provide most utility, seems to me to be a great leap forward in achieving
this balance.
It wont be perfect, will likely require many
iterations and there will be LOTS of resistance to it from within pharma (and
their shareholders) who may be relatively happy with the status quo. But I can
see many advantages at least in the underlying principles of rewarding those medicines
that are most useful to patients. Importantly, this also needs to be
accompanied by a strong willingness to disinvest in those medicines where we
don’t have robust evidence (yet) that they provide worthwhile utility and
value for money.
I’m sure the devil will be in the detail
– interesting times ahead!
Cheers
Head of EBT, NPC
--
Carlos A. Cuello-García, MD
Director, Centre for Evidence-Based Practice-Tecnologico de
Cochrane-ITESM coordinator. Professor of Paediatrics and Clinical Research
Avda. Morones Prieto 3000 pte. Col. Doctores. CITES 3er. piso,Monterrey NL,
México. CP64710
Phone. +52(81)88882154 & 2141. Fax: +52(81)88882148
www.cmbe.net
http://twitter.com/CharlieNeck
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