Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T04:56:45.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluating options for decision making on costly hospital drugs in Austria

Published online by Cambridge University Press:  14 May 2020

Sarah Wolf Open the ORCID record for Sarah Wolf [Opens in a new window] ,
Ingrid Zechmeister-Koss ,
Nicole Grössmann  and
Claudia Wild
Sarah Wolf
Affiliation:
Austrian Institute for Health Technology Assessment GmbH, Garnisongasse 7/20, 1090Vienna, Austria
Ingrid Zechmeister-Koss
Affiliation:
Austrian Institute for Health Technology Assessment GmbH, Garnisongasse 7/20, 1090Vienna, Austria
Nicole Grössmann
Affiliation:
Austrian Institute for Health Technology Assessment GmbH, Garnisongasse 7/20, 1090Vienna, Austria
Claudia Wild
Affiliation:
Austrian Institute for Health Technology Assessment GmbH, Garnisongasse 7/20, 1090Vienna, Austria
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

The aim of this study was to suggest options for a national and standardized process for the reimbursement of costly drugs provided in Austrian hospitals.

Methods

For answering the research questions, reimbursement processes of ten countries were investigated and the strengths and weaknesses of elaborated options of actions were analyzed, resulting in suggestions for solutions in the Austrian reimbursement processes for hospital drugs.

Results

Based on the information derived from the international analysis and the deliberation of the strengths and weaknesses on optional approaches, as well as, on the consideration of the existing reimbursement processes in Austria, three options to reorganize the current decentralized inpatient reimbursement process in Austria were suggested. The first option presents a process following the established processes of the decision making for outpatient drugs. The second option suggests stronger coordination of and cooperation across the existing processes of the nine regional “Pharmaceutical and Therapeutics Committees”. The third option proposes to expand the already established reimbursement process for non-drug interventions.

Conclusions

Evidence-based, transparent, fair and efficient resource allocations are needed for priority setting decisions. However, a decision process can be based on the best available evidence, can be fair and transparent, although it might be substantially more time-consuming. Thus, a pragmatic balance between quality, transparency and timeliness is crucial.

Keywords

Health technology assessmentReimbursement processesHospital drugs
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 3 , June 2020 , pp. 277 - 284
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mazzucato, M. High cost of new drugs: Why government must negotiate a better deal for publicly funded research. Br Med J. 2016;354:4136.CrossRefGoogle Scholar
World Health Organization (WHO) Report on the Fair Pricing Forum 2017. 2017. Available from: https://www.who.int/medicines/access/fair_pricing/fair_price_report/en/ (accessed October 4, 2019).Google Scholar
Verheijde, LJ. Health care costs and scarcity of health care resources. Manag Care: A Shared Responsib. 2006;22:1–30.Google Scholar
Vogler, S, Paris, V, Ferrario, A, Wirtz, VJ, de Joncheere, K, Schneider, P, et al. How can pricing and reimbursement policies improve affordable access to medicines? Lessons learned from European Countries. Appl Health Econ Health Policy. 2017;15:307–21.10.1007/s40258-016-0300-zCrossRefGoogle ScholarPubMed
Hauptverband der Sozialversicherungen Österreich (HVB) Erstattungskodex – EKO 2018. 2018. Available from: http://www.hauptverband.at/cdscontent/load?contentid=10008.637165&version=1515485239 (accessed October 23, 2018).Google Scholar
Wolf, S, Wild, C. Preisbildung und Arzneimittelerstattung im stationären Sektor in Österreich: Ansätze für einen transparenten und evidenzbasierten Prozess unter Berücksichtigung internationaler Erfahrungen. Ludwig Boltzmann Institut für Health Technology Assessment, contract no.: 109. 2018.Google Scholar
Daniels, N. Accountablity for reasonableness: Establishing a fair process for priority setting is easier than agreeing on principles. Br Med J. 2000;321:1.Google Scholar
Winkler, R, Stanak, M. HTA und Deliberation – für legitime(re), transparente(re) und gerechte(re) Entscheidungen im Gesundheitswesen. 2017. Available from: https://hta.lbg.ac.at/page/hta-und-deliberation-fuer-legitime-re-transparente-re-und-gerechte-re-entscheidungen-im-gesundheitswesen/de (accessed November 4, 2019).Google Scholar
Zentner, A, Velasco-Garrido, M, Busse, R. Methoden zur vergleichenden Bewertung pharmazeutischer Produkte. 2005. Available from: https://portal.dimdi.de/de/hta/hta_berichte/hta122_bericht_de.pdf (accessed May 24, 2018).Google Scholar
Paris, V, Belloni, A. Value in pharmaceutical pricing. Country profile: Canada. 2014. Available from: https://www.oecd.org/canada/Value-in-Pharmaceutical-Pricing-Canada.pdf (accessed May 23, 2018).Google Scholar
Sorenson, C, Drummond, M, Kanavos, P. Ensuring value for health care. The role of health technology assessment in the European Union. Euro Obs Health Syst Policies. 2008;1–179.Google Scholar
Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) General Methods Version 5.0. 2017. Available from: https://www.iqwig.de/en/methods/methods-paper.3020.html (accessed June 26, 2018).Google Scholar
de Folter, J, Trusheim, M, Jonsson, P, Garner, S. Decision-components of NICE's technology appraisals assessment framework. Int J Technol Assess Health Care. 2018;34:163–71.CrossRefGoogle ScholarPubMed
International Society For Pharmacoeconomics and Outcomes Research (ISPOR) Norwegian guidelines for pharmacoeconomic analysis in connection with applications for reimbursement. 2018. Available from: https://tools.ispor.org/PEguidelines/countrydet.asp?c=15&t=1 (accessed May 23, 2018).Google Scholar
European Network for Health Technology Assessment (EUnetHTA) An analysis of HTA and reimbursement procedures in EUnetHTA partner countries: final report. 2018. Available from: https://www.eunethta.eu/wp-content/uploads/2018/02/WP7-Activity-1-Report.pdf (accessed May 23, 2018).Google Scholar
Paris, V, Belloni, A. Value in pharmaceutical pricing. Country profile: Australia. 2013. Available from: https://www.oecd.org/health/Value-in-Pharmaceutical-Pricing-Australia.pdf. (accessed June 12, 2018).Google Scholar
Buruma, S.The Netherlands: All eyes on pharmaceutical expenditures in the hospital sector. 2015. Available from: https://axonhealthcare.nl/wp-content/uploads/2015/09/whitepaper-expensive-medicines-AxonSept2015.pdf. (accessed May 23, 2018).Google Scholar
Busse, R, Panteli, D, Henschke, C. Arzneimittelversorgung in der GKV und 15 anderen europäischen Gesundheitssystemen. Ein systematischer Vergleich. 2015. Available from: https://www.gkv-spitzenverband.de/media/dokumente/presse/pressekonferenzen_gespraeche/2015_2/pk_20150615_arzneimittel/06_Studie_Arzneimittelversorgung_Juni_2015.pdf (accessed July 4, 2018).Google Scholar
Hogan Lovells Publications EU Pricing & Reimbursement schemes in major European countries. 2014. Available from: https://www.hoganlovells.com/~/media/hogan-lovells/pdf/publication/eu-pricing--reimbursement-newsletter--november-2014_pdf.pdf (accessed May 17, 2018).Google Scholar
Panteli, D, Arickx, F, Cleemput, I, Dedet, G, Eckhardt, H, Fogarty, E, et al. Pharmaceutical regulation in 15 European countries. Health Syst Transit. 2016;18:1–143.Google ScholarPubMed
Bunzemeier, H. Finanzierung stationärer Krankenhausleistungen in Deutschland im Jahr 2018. 2018. Available from: https://www.krebsgesellschaft.de/ (accessed June 7, 2018).Google Scholar
Pontén, J, Rönnholm, G, Skiöld, P. PPRI Pharma Profil Sweden. 2017. Available from: http://whocc.goeg.at/Literaturliste/Dokumente/CountryInformationReports/PPRI_Pharma_Profile_Sweden_2017.pdf. (accessed June 7, 2018).Google Scholar
Gemeinsamer Bundesausschuss (G-BA) Die Nutzenbewertung von Arzneimitteln gemäß $ 35a SGB V. 2011. Available from: https://www.gba.de/institution/themenschwerpunkte/arzneimittel/nutzenbewertung35a/ (accessed June 26, 2018).Google Scholar
Norwegian Medicines Agency (NOMA) Retningslinjer om taushetsplikt i forbindelse med metodevurderinger. 2017. Available from: https://legemiddelverket.no/Documents/Offentlig%20finansiering%20og%20pris/Dokumentasjon%20til%20metodevurdering/taushetsplikt_metodevurderinger_jan%202017.pdf (accessed September 20, 2018).Google Scholar
Pharmaceutical Health Information System (PHIS) PHIS hospital pharma report 2010. 2010. Available from: http://whocc.goeg.at/Literaturliste/Dokumente/BooksReports/PHIS_Hospital%20Pharma_Report.pdf. (accessed June 12, 2018).Google Scholar