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Accuracy of budget impact estimations and impact on patient access: a hepatitis C case study

Author

Listed:
  • Joost W. Geenen

    (Utrecht University)

  • Cornelis Boersma

    (University of Groningen, University Medical Center Groningen
    Health-Ecore)

  • Olaf H. Klungel

    (Utrecht University)

  • Anke M. Hövels

    (Utrecht University)

Abstract

Background High budget impact (BI) estimates of new drugs limit access to patients due to concerns regarding affordability and displacement effects. The accuracy and methodological quality of BI analyses are often low, potentially mis-informing reimbursement decision making. Using hepatitis C as a case study, we aim to quantify the accuracy of the BI predictions used in Dutch reimbursement decision-making and to characterize the influence of market-dynamics on actual BI. Methods We selected hepatitis C direct-acting antivirals (DAAs) that were introduced in the Netherlands between January 2014 and March 2018. Dutch National Health Care Institute (ZIN) BI estimates were derived from the reimbursement dossiers. Actual Dutch BI data were provided by FarmInform. BI prediction accuracy was assessed by comparing the ZIN BI estimates with the actual BI data. Results Actual BI, from 1 Jan 2014 to 1 March 2018, was €248 million whilst the BI estimates ranged from €388–€510 million. The latter figure represents the estimated BI for the reimbursement scenario that was adopted, implying a €275 million overestimation. Absent incorporation of timing of regulatory decisions and inadequate correction for the introduction of new products were main drivers of BI overestimation, as well as uncertainty regarding the patient population size and the impact of the final reimbursement decision. Discussion BI in reimbursement dossiers largely overestimated actual BI of hepatitis C DAAs. When BI analysis is performed according to existing guidelines, the resulting more accurate BI estimates may lead to better informed reimbursement decisions.

Suggested Citation

  • Joost W. Geenen & Cornelis Boersma & Olaf H. Klungel & Anke M. Hövels, 2019. "Accuracy of budget impact estimations and impact on patient access: a hepatitis C case study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 857-867, August.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:6:d:10.1007_s10198-019-01048-z
    DOI: 10.1007/s10198-019-01048-z
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    References listed on IDEAS

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    1. Salah Ghabri & Josephine Mauskopf, 2018. "The use of budget impact analysis in the economic evaluation of new medicines in Australia, England, France and the United States: relationship to cost-effectiveness analysis and methodological challe," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 173-175, March.
    2. Livio Garattini & Katelijne Vooren, 2011. "Budget impact analysis in economic evaluation: a proposal for a clearer definition," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 499-502, December.
    3. Katelijne Vooren & Silvy Duranti & Alessandro Curto & Livio Garattini, 2014. "A Critical Systematic Review of Budget Impact Analyses on Drugs in the EU Countries," Applied Health Economics and Health Policy, Springer, vol. 12(1), pages 33-40, February.
    4. Swathi Iyengar & Kiu Tay-Teo & Sabine Vogler & Peter Beyer & Stefan Wiktor & Kees de Joncheere & Suzanne Hill, 2016. "Prices, Costs, and Affordability of New Medicines for Hepatitis C in 30 Countries: An Economic Analysis," PLOS Medicine, Public Library of Science, vol. 13(5), pages 1-22, May.
    5. Maarse, Hans & Jeurissen, Patrick & Ruwaard, Dirk, 2016. "Results of the market-oriented reform in the Netherlands: a review," Health Economics, Policy and Law, Cambridge University Press, vol. 11(2), pages 161-178, April.
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    Cited by:

    1. E.V. Popov, 2021. "Drivers of the Economy in the Context of the Coronavirus Pandemic," Journal of Applied Economic Research, Graduate School of Economics and Management, Ural Federal University, vol. 20(1), pages 5-30.

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    More about this item

    Keywords

    Hepatitis C; Budget impact; Budget impact accuracy; Direct-acting antivirals; Affordability; Pharmaceuticals;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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