6.02 The value of pharmaceuticals for the society should always be assessed
A better effect of the treatment and consequently less sickness may generally be regarded to have some financial advantages such as fewer hospitalisations and doctor's call, just as some financial advantages may be achieved because of a quicker resumption of work and daily tasks. An analysis of expenses and benefits of the new medicinal products, therefore cannot automatically be limited to the immediate expenses and benefits of medicinal products, just as an analysis cannot be limited by more or less casual planned sector limits (“boxes”). On the contrary, a need exists for including all relevant expenses and benefits in- and outside the health service, including considering the consequences of many different elements such as differences in the patients’ compliance, differences in services offered by the primary healthcare sector, the hospital sector and the social sector, and the implication of family relations and other social relations. The point is that the delimitation must happen on the basis of relevance.
The above-mentioned conditions may be described in so-called healthcare or cost benefit analyses. It should be a matter of course, that authorities, which make decisions on behalf of us all, disclose all relevant conditions.
Today we have an arrangement where the pharmaceutical companies voluntarily can submit a cost benefit analysis in connection with an application for reimbursement. The fact that the arrangement is voluntary and aims at the companies, do not exempt the authorities from making a qualitative assessment of the same elements when decisions are made on reimbursement based on financial considerations. Today, according to the regular practice the Danish Medicines Agency’s decisions often are based on a simple comparison of prices of the new medicinal products and previous treatment procedures combined with a more or less implicit assumption that there are no significant differences in the results of the treatment.
Lif believes:
- Decisions on reimbursement for use of new medicines must take into consideration all health economic aspects of the use of the medicinal product. The financial considerations have to include relevant advantages in connection with expenses inside and outside the health service,
- that the health economic method and analysis must be used better and broader than we do today when we assess medicinal products’ rational use in the Danish health service,
- that the assessment of a medicinal product’s importance to the treatment of diseases or the prevention of disease should be based on the same principles that are included in a medical technology assessment – the technology itself, the importance to the patients, the organisational frames and the financial conditions,
- that the assessment of medicinal products should be carried out on the same terms and according to the same principles as other healthcare technologies are assessed. It should be the same organisational unit that assesses the societal importance of the use of all new technologies in the Danish health service.
Read more in the leaflet: “Lif’s views on reimbursement”
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