Financial considerations on technology acceptance
DOI: 10.22591/magyurol.2017.4.bidloj.145
Authors:
Bidló Judit szakmai főtanácsadó
Nemzeti Egészségbiztosítási Alapkezelő, Budapest
Summary
Compared to 10 or 15 years ago, the drug mixture has completely changed. The products on the market today are of course much more efficient, but also much higher in price, and correspondingly, it’s become much more challenging for payers to cover them – especially with limited resources. It is crucial now more than ever to define specific criteria and appropriate benchmarks to ensure that drugs admitted into reimbursement perform as expected.
In Hungary there are 2 major reimbursement categories: normative and indication-based. The normative says that in every registered indication, every doctor can prescribe it within the certain reimbursement level that we defined in the regulation. Whereas, for indication-based, the Ministry of Human Capacities dictates the doctors who can prescribe these products, usually specialists, and also sometimes the centres as well.
Evaluating a new medicine for the formulary involves not only efficacy, safety and quality, but also cost and cost-effectiveness. The quality-adjusted life year (QALY) is routinely used as a summary measure of health outcome for economic evaluation, which incorporates the impact on both the quantity and quality of life. Key studies relating to the QALY and utility measurement are the sources of data.
But additionally to the cost-effectiveness itself it is always important to take into consideration other factors such as therapeutic added value and budget impact. One of the primary challenges now is accommodating the growing premiums associated with increasingly innovative therapies and assessing alternative financing methods to introduce them into the system.