Tag Archives: Access

Why all the negativity around National Health Insurance in South Africa?

23 Aug
National-Health-Insurance

Why all the negativity around national health insurance (NHI) in South Africa? There is so much bad news such as comments by the Solidarity Research Institute that NHI will collapse the healthcare system, the Free Market Foundation believes the NHI will be a gateway for corruption, and Alex van den Heever at Wits University thinks […]

Value-Based Pricing of New Technologies

13 Aug
price and value balance sign

Health insurance companies and governments use strong financial and administrative barriers to manage the utilization of new technologies. Cost-sharing (co-insurance or co-payments), prior authorization, clinical panel reviews, therapeutic reference pricing, and new technology appraisals are designed to manage the incremental uptake of new technologies. These technologies, for example, PCSK-9 inhibitors and enzyme replacement therapies, are […]

Market Access Landscape in the Middle East:The Next Five Years

06 Jun
Middle-East

The market access landscape in the Middle East is changing rapidly. The growth of private health insurance markets in the Gulf is a significant catalyst for the re-organisation of private sector stakeholders and improvements in internal reimbursement policies. In the past, Payors were relatively generous in their reimbursement of new technologies, but in the next […]

Is Real-World Evidence all it’s trumped-up to be?

10 Apr
multiplechro

There’s so much discussion around Big Data and Real-World Evidence (RWE) in improving access to medicines. RWE is clinical data collected after the publication of clinical trials used for marketing authorization. Sources may include health insurance claims databases, patient registries, hospital patient records, among others. Clinical trials are by design the gold standard for new […]

Does the pharmaceutical industry bribe the FDA?

09 Aug
fda-logo-small

It’s not the type of question we’re asked every day, so it sparked our interest, particularly the assumption that something like this is possible. Opinion on the subject is divided. They range from ideas that anything related to the pharmaceutical industry is tainted, in this case the FDA, to opinions from scientists and policy experts […]

South Africa’s Private Health Insurance Industry: A Strategic National Asset under Threat?

11 Jul
Emergency

South Africa’s Cabinet of Ministers recently approved a White Paper on National Health Insurance aimed at moving the policy of universal health coverage further down the road. A National Health Insurance system would result in an integrated healthcare system founded on the principles of solidarity and redistribution of healthcare resources. The basic idea is that […]

WHO’s serious reservations on Value-Based Pricing: Conflicts and Nuances

08 Jun
WHO Fair Pricing Forum Carapinha & Company

On May 10 and 11, the WHO Fair Pricing Forum met to discuss improvements to medicine pricing practices and pricing approaches that balance public health needs and incentives for pharmaceutical research and development. The Forum was established to facilitate the exchange of insights on fairer medicine pricing systems, identification of research gaps to support improvements, […]

The Globalization of NICE’s Health Technology Appraisals

01 May
NICE-Small

The National Institute for Health and Care Excellence (NICE) in England often comes up in conversations on medicine reimbursement. The sequence of events goes something like this: a new medicine is planned for launch in a growth market (mostly middle-income countries), but the government and private health insurance companies are uncertain of its economic and […]

En garde QALY! Is your end nigh?

05 Apr
qalys

The Spanish Ministry of Health recently rejected the use of QALYs in cost-effectiveness analyses. At issue is the subjective nature of the parameters used to develop the QALY. The Quality-Adjusted Life-Years (QALY) is a product of the change in utilities associated with a treatment multiplied by the time of treatment exposure. The QALYs gained combined […]

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