[Current problems in assessing drug prices].

Medicina (Florence, Italy) Pub Date : 1989-10-01
C Lucioni
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Abstract

Two reasons provide historical justification for controlling drug prices: safeguarding the consumer and safeguarding public demand. Due to the increased presence of the "third payer" in public health systems this second reason has become more important. Nevertheless, over the last decade, a third purpose has attached to public control of prices: promotion of drug manufacturers economic development. The justification offered for this is that development of pharmaceutical companies contributes to the economic growth of the host country by creating employment, exports and research activity. The situations in Germany, Great Britain and United States are often cited in support of this thesis. As a model for price policy in Italy, however, it has not been successful. The rapid growth of prices in fact has not created greater employment and the foreign exchange deficit has risen rapidly. In other words the growing cost of drugs to the National Health Service has not produced hoped-for economic benefits. It would therefore be opportune to modify the mechanisms of price control by seeking a better balance in the interests involved (safeguarding public demand versus manufacturers economic growth). Methodologies available point to the evaluation of the therapeutic utility of a drug as a useful tool for this purpose. By this method the price of a new drug may only be higher than that of a drug already on the market if its therapeutic utility (which does not coincide only with clinical effectiveness) is greater. Appropriate evaluation techniques of benefits deriving from a new drug (cost-effectiveness and cost-utility) do exist and can be taken into consideration in a new method of calculating drug price.

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[目前评估药品价格的问题]。
两个原因为控制药品价格提供了历史依据:保护消费者和保护公共需求。由于公共卫生系统中“第三付款人”的增加,第二个原因变得更加重要。然而,在过去十年中,对价格的公共控制附加了第三个目的:促进药品制造商的经济发展。对此提出的理由是,制药公司的发展通过创造就业、出口和研究活动,有助于东道国的经济增长。德国、英国和美国的情况经常被引用来支持这一论点。然而,作为意大利价格政策的典范,它并不成功。事实上,物价的快速增长并没有创造更多的就业机会,外汇赤字也迅速上升。换句话说,英国国民医疗服务体系(nhs)不断增长的药品成本并没有产生人们所希望的经济效益。因此,通过在所涉及的利益之间寻求更好的平衡(保障公共需求与制造商的经济增长)来修改价格控制机制是合适的。现有的方法指出,评估药物的治疗效用是实现这一目的的有用工具。通过这种方法,一种新药的价格只有在其治疗效用(不仅与临床效果一致)更大的情况下才可能高于市场上已有的药物。对新药产生的效益(成本效益和成本效用)的适当评价技术确实存在,并且可以在计算药品价格的新方法中加以考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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