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Role of Economic Evaluations on Pricing of Medicines Reimbursed by the Italian National Health Service

Author

Listed:
  • Pierluigi Russo

    (Italian Medicines Agency)

  • Matteo Zanuzzi

    (Italian Medicines Agency)

  • Angelica Carletto

    (Italian Medicines Agency)

  • Annalisa Sammarco

    (Italian Medicines Agency)

  • Federica Romano

    (Italian Medicines Agency)

  • Andrea Manca

    (University of York)

Abstract

Objective The main objective of this study was to explore the extent to which the incremental cost-effectiveness ratio (ICER), alongside other factors, predicts the final outcome of medicine price negotiation in Italy. The second objective was to depict the mean ICER of medicines obtained after negotiation. Methods Data were extracted from company dossiers submitted to the Italian Medicines Agency (AIFA) from October 2016 to January 2021 and AIFA’s internal database. Beta-based regression analyses were used to test the effect of ICER and other variables on the outcome of price negotiation (ΔP), defined as the percentage difference between the list price requested by manufacturers and the final price paid by the Italian National Health Service (INHS). Results In our dataset of 48 pricing and reimbursement procedures, the ICER before negotiation was one of the variables with a major impact on the outcome of negotiation when ≥ 40,000€/QALY. As resulting from multiple regression analyses, the effect of the ICER on ΔP seemed driven by medicines for non-onco-immunological and non-rare diseases. Overall, the negotiation process granted mean incremental costs of €64,688 and mean incremental QALYs of 1.96, yielding an average ICER of €33,004/QALY. Conclusions This study provides support on the influence of cost-effectiveness analysis on price negotiation in the Italian context, providing an estimate of the mean ICER of reimbursed medicines, calculated using net confidential prices charged by the INHS. The role and use of economic evaluations in medicines pricing should be further improved to get the best value for money.

Suggested Citation

  • Pierluigi Russo & Matteo Zanuzzi & Angelica Carletto & Annalisa Sammarco & Federica Romano & Andrea Manca, 2023. "Role of Economic Evaluations on Pricing of Medicines Reimbursed by the Italian National Health Service," PharmacoEconomics, Springer, vol. 41(1), pages 107-117, January.
    • Handle: RePEc:spr:pharme:v:41:y:2023:i:1:d:10.1007_s40273-022-01215-w
    DOI: 10.1007/s40273-022-01215-w
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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.
    2. Anthony H. Harris & Suzanne R. Hill & Geoffrey Chin & Jing Jing Li & Emily Walkom, 2008. "The Role of Value for Money in Public Insurance Coverage Decisions for Drugs in Australia: A Retrospective Analysis 1994-2004," Medical Decision Making, , vol. 28(5), pages 713-722, September.
    3. Martin Wenzl & Suzannah Chapman, 2019. "Performance-based managed entry agreements for new medicines in OECD countries and EU member states: How they work and possible improvements going forward," OECD Health Working Papers 115, OECD Publishing.
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