200 pm Getting to Lower Prescription Drug Prices in the United States How Do Other Countries Do It Educational Teleconference INTRODUCTION Vice President and Director International Health Policy and Practice Innovations the Commonwealth Fund ID: 1044054
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1. Tuesday, September 25, 20182:00 p.m.Getting to Lower Prescription Drug Prices in the United States: How Do Other Countries Do It?Educational Teleconference
2. INTRODUCTIONVice President and Director, International Health Policy and Practice Innovations, the Commonwealth FundRobin OsbornEducational Teleconference| September 25, 2018Vice President, Controlling Health Care Costs and Advancing Medicare, the Commonwealth FundShawn Bishop
3. Professor, Health Services and Policy, The University of British ColumbiaSteve MorganEducational Teleconference| September 25, 2018
4. Under the most favorable assumptions for USA(assume 50% brand rebates in USA only)$-billionsSame idea, if the USA had Canada’s use and cost levelsSpending at US Rx use and cost levels$44.9$39.9Cost at comparators’ use and cost levels$23.0$23.0Total difference$21.9$17.0Difference because of more (or less) medicine use-$4.2$0.6Difference because of prescribing patterns$6.7$4.4Difference because of prices$20.1$12.0Comparators: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United KingdomDrug classes: hypertension, pain, cholesterol, non-insulin diabetes, gastrointestinal preparations, and antidepressantsSource: Morgan et al, Health Policy, 2018 Sep, 122(9):1012-1017. doi: 10.1016/j.healthpol.2018.07.005STEVE MORGANExpenditure on primary care prescription drugs in the United States versus ten comparable high-income countries, 2015
5. Ruth LopertAdjunct Professor, George Washington School of Public Health, former Chief Medical Officer, Australia’s Therapeutic Goods AdministrationEducational Teleconference| September 25, 2018
6. RUTH LOPERTAustralian Pharmaceutical Benefits SchemeNational program providing comprehensive pharmaceutical coverage in the community, established nearly 70 years agoComparative cost effectiveness a mandatory criterion for formulary inclusion since early 90sA drug cannot be listed at a higher price than existing alternatives unless for some patients at least it provides an increment in clinical benefitConcept of ‘purchasing outcomes’ rather than drugs – focus is on value for money rather than price
7. RUTH LOPERTAustralian Pharmaceutical Benefits SchemeTwo levels of patient co-paymentsFor general beneficiaries, up to AUD 39.50 (USD 28.80) per itemFor concessional beneficiaries, AUD 6.40 (USD 4.70) per itemCo-payment amounts are adjusted on 1 January each year in line with the Consumer Price Index (CPI).Safety Nets (calendar year) – apply to individuals, couples and familiesFor general beneficiaries, AUD 1,521.80 (USD1108), thereafter co-payments at the concessional rateFor concessional beneficiaries, AUD 384.00 (USD 280), thereafter items dispensed without co-payment
8. Leonard D. Schaeffer Endowed Chair in Health Economics, University of California BerkeleyJames RobinsonEducational Teleconference| September 25, 2018
9. Question and AnswerEducational Teleconference| September 25, 2018