Abstract
Drug pricing is one of the key levers that determine the profitability of a
drug company. Premium pricing of a new drug helps cover the high cost of
innovation and helps run a profitable enterprise. But the recent onslaught of
generics, as well as shrinking government and corporate healthcare budgets, is
threatening the time-tested models, leading to higher pricing pressures for
pharmaceutical and biotech companies in the coming years. In this environment,
executives in these companies and the consultants who service them need better
information to make the most profitable decisions.
Kalorama Information' s A Guide to Drug Pricing and Reimbursement provides
considerable detail on the this all-important area of pharmaceutical marketing
strategy. The guide describes pricing strategies for specific results,
including:
- Gaining Market Share
- Defending Market Share
- Enhancing Brand Loyalty
- Gaining New Customers
- Improving Margins
- Utilizing Capacity
The result of exhaustive research into recent pricing trends as well as
interviews with top pharmaceutical executives, the Guide provides executives
in pricing decision capacities with critical information needed to arrive at
the most effective strategy:
- Useful statistics detailing the Overall Pharmaceutical Pricing
Environment, including Healthcare Expenditures, Pharmaceutical
Expenditures and Drug Prices in Select Countries as well as Biopharmaceutical
R&D Expenditures
- Updated Medicare Reimbursement Information for Parts A,B,C and D
- The Development phases in which it is most important to consider
pricing
- Overview of U.S. Pharmaceutical Market (including Healthcare
Spending, Promotional Spending, Average Co Payments, Generic Drug Trends,
Single Source Brand Vs. AWP and more.)
- Pricing Strategies for the European Market
- Japanese Market Pricing and Reimbursement Strategies.
Drug pricing and reimbursement also differs widely across the globe due to the
huge disparity in economic situations of various countries, and this global
report addresses the pricing environments in:
Pricing and reimbursement will remain one of the most talked about industry
issues going into the next decade. This report aims to provide a holistic view
on pricing and reimbursement across the globe. This report enables executives
to make proactive decisions and to craft their responses to the changing
dynamics of the market.
Table of Contents
Executive Summary
- Drug Pricing and Reimbursement: Strategic Overview
- Factors affecting Pharmaceutical Expenditur
- Key Issues and Challenges
- Pricing Strategies
- Regional Pricing Differences
- Scope and Methodology
- Reasons for Conducting the Study
Drug Pricing and Reimbursement: Strategic Perspectives
- 2.1. Background
- 2.2. Global healthcare costs and their Impact on GDP
- 2.3. Drug Costs and Affordability
- 2.3.1. Price Variability across countries
- 2.4. Factors contributing to Drug Expenditures
- a) Volume Growth
- b) Rising Prices
- 2.5. Pharmaceutical Pricing and Ethics
- 2.5.1. Differential Pricing
- 2.5.2. HIV/AIDS Pricing & Ethics
Pricing Strategies
- 3.1. Background
- 3.2. Pricing Strategies: Goals
- 3.2.1. Market Share
- 3.2.2. Defending Market share
- 3.2.3. New Customers
- 3.2.4. Enhancing Brand Loyalty
- 3.2.5. Improving Margins
- 3.2.6. Capacity Utilization
- 3.3. Pricing Decisions: Types
- 3.3.1. Traditional Pricing
- 3.4. Role of Pricing Function in Price setting
- 3.5. Pricing and Pharmacoeconomics
- 3.6. Price Optimization
- 3.7. Pricing in the Product Development Process
- 3.7.1. Background
- 3.7.2. The First Price Estimate
- 3.7.3. Improving Pricing in the Product Development Process
Current Pricing and Reimbursement Trends in the USA
- 4.1.U.S. Healthcare Expenditures
- 4.1.1. National Prescription Drug Expenditures
- 4.1.2 Pharmaceutical Costs
- 4.1.2.3. Factors for rise in pharmaceutical costs
- 4.1.3. Future trends in Pharmaceutical Costs
- 4.1.3.2. Increased Generic Penetration
- 4.1.3.2. Rising Consumerism
- 4.1.3.4. Shifting Payor Mix
- 4.1.3.5. Cost Containment and the Formulary
- 4.1.3.6. Basis of price determination
- 4.2. Pricing mechanism in USA
- 4.3. Price Movement
- 4.3.1 Impact of Supply Chain on Price
- 4.3.2. Supply chain and price differentials
- Retail Sector
- Non retail sector
- 4.4. Key Pricing measures
- 4.4.1. Background
- a) Average Manufacturer' s Price (AMP)
- b) Average Sales Price (ASP)
- c) Average Wholesale Price (AWP)
- d) Estimated Acquisition Cost (EAC)
- e) Federal Supply Schedule.
- f) Federal Upper Limit (FUL)
- g) Maximum Allowable Cost (MAC)
- h) Wholesale Acquisition Cost (WAC)
- 4.5. Drug Pricing Litigations
- 4.6. Pricing Dynamics
- Single-Source Drugs
- Multiple-Source Drugs
- 4.7. Pricing and customer segments
- 4.7.1 Background
- 4.7.2 Pharmacy Benefit Managers
- Background
- PBM role
- Cost containment Strategies
- Pharmacies
- PBMs' Negotiated Payments to Pharmacies
- PBMs' Payments to Pharmacies
- 4.7.3. Mail-Order Pharmacies
- 4.7.4. Cash Customers
- 4.7.5. Government Markets
- 4.7.5.1. Federal Supply Schedule
- 4.7.5.2. 340B Drug Discount Program
- 4.7.5.3. Medicare
- a) PART A
- b) PART B
- Medicare Reimbursements
- c) Part C (Medicare Advantage)
- d) PART D
- Future Challenges
- 2008 Changes in Medicare Part D Payments
- Calculation of the Low-Income Benchmark Premium Amounts
- Annual Updates to Medicare Part D Benefit Parameters
- 4.7.5.4. Medicaid
- 4.7.6. Third party payors
- Managed care business structure
- Healthcare maintenance organizations (HMO)
- Point of service (PoS)
- Preferred provider organizations (PPO)
- MCOs and Pharmacy Benefit Managers (PBMs) relationships
- Co-payments and cost-reduction initiatives
- Managed Care Contracting: Pharmaceutical Manufacturers' Perspective
- Managed Care Business Goals
- Managed Care Strategy
- 6. Monitoring Performance
- 4.7.7. Emerging Issues
- 4.7.7.1.Drug Price Transparency in United States
- 4.7.7.2. Wal-Mart and $4 Generics
- 4.7.7.3. Average Wholesale Price and First Data Bank
Current Pricing and Reimbursement Trends in Europe
- 5.1. Background
- 5.1.1 EU Pricing Environment
- 5.1.2. Reimbursement Mechanisms
- 5.1.3. Pricing and Reimbursement impact on new product launch sequence
- 5.1.4. Drug Budgets
- 5.1.5. Pricing and Reimbursement Overview
- U.K. and Germany
- France, Italy and Spain
- 5.1.6. Parallel Trade
- Germany
- 5.2.1. Background
- 5.2.2. Statutory Health Insurance Funds
- 5.2.3. Statutory Health Insurance Market
- FRANCE
- 5.3.1. Background
- 5.3.2. Regulatory Affairs in France
- 5.3.3. Regulations
- UK
- 5.4.1.Pricing System
- 5.4.2. Pricing of New Products
- 5.4.3. Pricing Methods for Generic Products
- 5.4.4. Reimbursement
- ITALY
- 5.5.1. Pricing Systems
- 5.5.2. Reimbursement
- SPAIN
- 5.6.1. Pricing Systems
- 5.6.2. Reference Pricing System
- 5.7.Tackling Parallel Trade
Current Pricing and reimbursement Trends in Japan
- 6.1. Background
- 6.2. Japanese Healthcare System
- Employee' s Health Insurance Plan
- National Public Health Insurance Plan
- 6.2. Bungyo
- 6.3. Reimbursement system
- 6.3. The R-Zone and regular price decreases
医薬品
その他のカテゴリ
FAQ