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10 Years of AMNOG: What is the Willingness-to-Pay for Pharmaceuticals in Germany?

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  • Melanie Büssgen

    (University of Hamburg)

  • Tom Stargardt

    (University of Hamburg)

Abstract

Objectives The German Pharmaceutical Market Restructuring Act (AMNOG, 2011) is a two-stage process to regulate the price of new pharmaceuticals in which price negotiations are conducted based on evidence-based medical benefit assessments using data from prior clinical trials. Although the act does not explicitly set a willingness-to-pay (WTP) threshold, the process itself implicitly establishes a WTP for health improvement. We evaluated the implicit WTP for prescription pharmaceuticals post-AMNOG in the German healthcare system from the decision-maker/payer perspective. Methods We extracted data on patient-group-specific annual treatment costs and endpoints from 2011 to 2021 from the dossiers assessed by the German Federal Joint Committee (FJC; Gemeinsamer Bundesausschuss). Using incremental cost-effectiveness ratios (ICERs), we calculated a WTP for the indications (I) diabetes, (II) cardiovascular disease, and (III) psoriasis weighted according to patient group size, first from the perspective of the decision-maker (approach A), and second from the perspective of the industry (approach B). To put clinical outcome measures into relation to one another, minimum clinically important differences (MCIDs) were derived from the literature and compared. Results The annual treatment costs of newly authorized drugs were substantially higher (both pre- and post-negotiation) than that of their comparators (e.g., psoriasis, pre-negotiation: €20,601.59, post-negotiation: €16,763.57; comparators: €5178.00). However, although newly launched drugs were more expensive than their comparators, they brought greater medical benefits and were more aligned with value (r = 0.59, P

Suggested Citation

  • Melanie Büssgen & Tom Stargardt, 2023. "10 Years of AMNOG: What is the Willingness-to-Pay for Pharmaceuticals in Germany?," Applied Health Economics and Health Policy, Springer, vol. 21(5), pages 751-759, September.
    • Handle: RePEc:spr:aphecp:v:21:y:2023:i:5:d:10.1007_s40258-023-00815-7
    DOI: 10.1007/s40258-023-00815-7
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    References listed on IDEAS

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    1. Valérie Paris & Annalisa Belloni, 2013. "Value in Pharmaceutical Pricing," OECD Health Working Papers 63, OECD Publishing.
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