Valerie Paris provides some insight into the thinking at the OECD  concerning pharmaceutical policy. While Paris promotes the need to standardize HTA across markets, what is overlooked are unique incentives and disincentives at the country-level that may work against a process of standardization. This may range from structural aspects of a health care system, reimbursement mechanisms, ownership of health care facilities, and many other aspects that will reflect in data collected for HTAs. Paris claims there is little known about risk-sharing agreements, but she overlooks a wave of literature that dissects such agreements including the two papers I published in 2008 on this subject, paper 1 and paper 2.

Joao

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Leela Barham talks to Valérie Paris of the OECD’s Health Division about how policymakers and pharma firms can achieve better value for money. At a time of considerable financial challenge, options for policy makers to achieve better value for money across the entire health system are much needed. In late 2009, the OECD published options for policy makers, including ensuring efficiency in pharmaceutical expenditure. Despite differences across national health systems, cultures, and the myriad policies affecting pricing and reimbursement, Valérie Paris, from the Health Division of the OECD, says that there are some options that should be explored. Her pharmaceutical policy checklist includes:
* Obtaining value for money while promoting future innovation by considering relative cost-effectiveness in pricing and purchasing decisions, while ensuring that rewards to innovation are consistent with the value of benefits offered;
* Seeking opportunities for establishing price-volume agreements or confidential rebates when value-based unit prices cannot be established (due to risk of parallel trade, for example);
* Exploring the potential for risk-sharing arrangements to reduce the financial risk presented by new medicines when information on costs and effects is insufficient;
* Encouraging generic substitution and price competition in the off-patent market;
* Creating incentives for physicians, pharmacists and patients to promote the appropriate prescribing, dispensing and use of medicines, recognizing that expenditure includes volume/mix as well as price components;
* Considering whether there are opportunities for efficiencies in the distribution chain;
* Ensuring that overall healthcare spending efficiency is not compromised by efforts to improve efficiency of pharmaceutical expenditure.

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