Drug Price Calculation and Pharmacoeconomics Pathways to Application
Toshiya Ikeda, Full-time Lecturer, Department of Health Care Policy and Management, Keio University School of Medicine
Shuji Onozuka, Senior Researcher, Pharmaceutical and Industrial Policy Research Institute
(No.19: Published in May 2004)
Pharmacoeconomic research is a methodology that examines both the costs and effects of drug therapies and quantitatively evaluates their economic efficiency. In other countries, the use of pharmacoeconomics in policy making, such as in determining whether insurance reimbursement is available, has been progressing. In Japan, on the other hand, although the possibility of using pharmacoeconomics in policy making has often been pointed out, concrete use of pharmacoeconomics has lagged behind.
Under the National Health Insurance (NHI) drug price standard system, a variety of additional fees are added to the price of new drugs based on the Comparable Drug Efficacy Comparison Method. However, the additions are not always based on scientific evidence. By referring to the results of pharmacoeconomic studies in determining the addition rate and other aspects of drug price calculation, it may be possible to calculate prices based on scientific evidence that appropriately reflects the clinical and economic value of drugs. However, several issues need to be addressed in order to use the results of pharmacoeconomic studies in drug price calculation situations, such as who conducts the studies, when and how the studies are conducted, how the results are evaluated, and how to ensure the quality of the studies.
This research paper provides an overview of the methods of pharmacoeconomic research, examines how pharmacoeconomic research is utilized in policy making in other countries, discusses the status of submission of pharmacoeconomic research materials and analytical methods in drug price negotiations for new drugs in Japan based on the results of a questionnaire survey of pharmaceutical companies, and reviews published papers on pharmacoeconomic research for new drugs. Finally, we reviewed published papers on pharmacoeconomics research on new drugs. Finally, based on the above, we discussed the challenges and prospects for improving the conditions for using pharmacoeconomic research for drug price calculation in Japan.