Revisions to Brazil's drug price framework are coming - what's included and what's missing? Our analysts provide th… https://t.co/8s17gnKCXf
Taking the pulse of international reference pricing
What a difference a year (or two) makes. When we published the 2017 edition of our International Reference Pricing Guidebook, we did so under the banner " IRP is dead, long live IRP!" This was our nod to the fact that, in an era of managed-entry agreements, patient access schemes and other such instruments, a legitimate question has been posed over the longevity of IRP: to the extent that visible prices in reference markets increasingly mask varied types of concessions, has IRP outlived its usefulness?
As we remarked in the 2017 edition of our study, in the final analysis, IRP remains alive and kicking. Despite the inability to pierce the veil of confidential discounting, this policy tool continues to feature prominently in the pricing framework of many markets, mature and emerging alike.
As we currently finalize the 2019 edition of our Guidebook, we are struck by the extent to which the intervening period reinforces this observation.
Looking back over just the past few months, we've seen a veritable wave of IRP reforms:
- As of 1 April, Bulgaria's reference basket has been streamlined and consolidated to do away with the old primary vs. secondary basket distinction; the IRP formula remains unchanged to reference the lowest price in the reference basket
- In Russia, late last year, a significant number of reference countries were axed from the basket, and more recently, provisions have been made for mandatory re-registration of prices
- Greece has seen a full overhaul of its pricing framework, introducing a new reference basket and IRP formula in the process
- In Ukraine, price controls involving IRP have now been extended to a subsection of the National List of Essential Medicines, relying on the same reference basket as the Affordable Medicines pilot, but introducing a new formula
- In Malaysia, the cabinet has approved new controls on pharmaceutical prices involving IRP, with implementation pending industry consultation
…. and the list goes on. Of course, the spectre of IRP introduction in the US, in one form or another, looms large in the background, with potentially game-changing consequences for industry.
This continued investment in IRP by payers and policymakers worldwide reflects appreciation for the utility of the tool. Often positioned alongside other decision-making criteria, or referred to in the context of negotiation, IRP continues to generate important benchmarks and points of leverage that payers are not so quick to relinquish.
For industry, amidst this backdrop of IRP policy churn, in-depth, nuanced insights on policy evolution are mission-critical. Maintaining a structured view of the many IRP parameters in each market - including basket composition, frequency of re-referencing, scope of medicines covered, exchange rate mechanisms, and more - is paramount in order to account for the complexity and interconnectivity of the global IRP landscape.
If there is a clear lesson from our work on the 2019 edition of the Guidebook so far, it is that IRP is decidedly less dead than it was in years prior.
- Brazil finally edges towards first drug pricing reform after two years – is it a missed opportunity?
- Will IRP upend Czech orphan drug reforms?
- Variations on an IRP theme: How payers are repurposing pricing policies for new categories of medicines
- Pharmaceutical and healthcare sectors jointly top global PMI ranking for first time
- Will physicians become more difficult to find in America?
- California's Medicaid pharmacy "carve-out" set to boost state's negotiating power, introduce IRP for drugs
- Trend towards HTA collaboration boosts need for data
- Barriers to market access for innovative medicines increase in the COVID era
Major changes to Czech P&R regulations for orphan and high-cost drugs set to expand access. What role will IRP play… https://t.co/bQcVCG5jut