Zaric Gregory S
Richard Ivey School of Business, University of Western Ontario, London, Canada.
Health Econ. 2008 Nov;17(11):1277-94. doi: 10.1002/hec.1332.
Limited use conditions (LUCs) are a method of directing treatment with new drugs to those populations where they will be most cost effective. In this paper we investigate how a drug manufacturer could determine pricing and LUCs to maximize profits. We assume that the payer makes formulary decisions on the basis of net monetary benefits, that the disease can be modeled using a Markov model of disease progression, and that the drug reduces the probability of progression between states of the Markov model. LUCs are expressed as a range of probabilities of disease progression over which patients would have access to the new drug. We assume that the manufacturer determines the price and LUCs in order to maximize profits. We show that an explicit trade-off exists between the drug's price and the use conditions, that there is an upper bound on the drug price, that the proportion of the population targeted by the LUC does not depend on quality of life or costs in each health state or the payer's willingness to pay, and that high drug prices do not always correspond with high profits.
有限使用条件（LUCs）是一种将新药治疗导向最具成本效益人群的方法。在本文中，我们研究了药品制造商如何确定定价和有限使用条件以实现利润最大化。我们假设支付方基于净货币收益做出药品目录决策，疾病可以用疾病进展的马尔可夫模型进行建模，并且药物降低了马尔可夫模型状态之间进展的概率。有限使用条件表示为患者能够获得新药的疾病进展概率范围。我们假设制造商确定价格和有限使用条件以实现利润最大化。我们表明，药物价格和使用条件之间存在明确的权衡，药物价格存在上限，有限使用条件所针对的人群比例不取决于生活质量、每个健康状态下的成本或支付方的支付意愿，并且高药价并不总是对应高利润。
