预测英国国民保健制度中药品的支出。

Projecting expenditure on medicines in the UK NHS.

机构信息

Office of Health Economics, 7th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK.

出版信息

Pharmacoeconomics. 2013 Oct;31(10):933-57. doi: 10.1007/s40273-013-0082-1.

DOI:10.1007/s40273-013-0082-1

PMID:24037786

Abstract

BACKGROUND

Expenditure on medicines is a readily identifiable element of health service costs. It is the focus of much attention by payers, not least in the UK even though the cost of medicines represents less than 10 % of total UK National Health Service (NHS) expenditure. Projecting future medicines spending enables the likely cost pressure to be allowed for in planning the scale and allocation of NHS resources. Simple extrapolations of past trends in expenditure fail to account for changes in the rate and mix of new medicines becoming available and in the scope for windfall savings when some medicines lose their patent protection. The objective of this study is to develop and test an improved method to project NHS pharmaceutical expenditure in the UK for the period 2012-2015.

METHODS

We have adopted a product-by-product, bottom-up approach, which means that our projections are built up from individual products to the total market. Our projections of the impact of generic and biosimilars entry on prices and quantities of medicines sold, and of the rate of uptake of newly launched medicines, have been obtained from regression analysis of UK data. To address uncertainty, we have created a baseline and two other illustrative scenarios. We have compared our projections with actual expenditure for 2012.

RESULTS

Our projections estimate that, between 2011 and 2015, with no change in policy or price regulation, the UK total medicines bill would increase at an average compound annual growth rate (CAGR) of between 3.1 and 4.1 %. Total NHS spending on branded medicines and total NHS spending on generics are projected to increase at average CAGRs of 0.5-1.8 and 10.0-11.0 %, respectively, over the same time period. For the total market, the actual growth rate for 2012 lay within our projected range.

CONCLUSIONS

Our methodology provides a useful framework for projecting UK NHS medicines expenditure over the medium term and captures the impacts of existing medicines losing exclusivity and of new medicines being launched onto the market.

摘要

背景

药品支出是卫生服务成本中一个显而易见的部分。它是支付者关注的焦点，在英国尤其如此，尽管药品成本仅占英国国民健康服务体系（NHS）总支出的不到 10%。预测未来的药品支出可以在规划 NHS 资源的规模和分配时，考虑到可能的成本压力。简单地对过去的支出趋势进行外推，并不能说明新药的供应速度和组合的变化，以及当某些药品失去专利保护时可能获得意外节省的情况。本研究的目的是开发和测试一种改进的方法，以预测英国 NHS 药品支出在 2012-2015 年期间的情况。

方法

我们采用了一种逐个产品、自下而上的方法，这意味着我们的预测是从单个产品到整个市场逐步建立起来的。我们对仿制药和生物仿制药进入市场对药品销售价格和数量的影响，以及新推出药品的采用速度的预测，是通过对英国数据的回归分析得出的。为了解决不确定性，我们创建了一个基线和另外两个说明性情景。我们将我们的预测与 2012 年的实际支出进行了比较。

结果

我们的预测估计，在 2011 年至 2015 年期间，如果政策或价格监管没有变化，英国药品总支出将以 3.1%至 4.1%的复合年增长率（CAGR）增长。预计在同一时期，品牌药品的 NHS 总支出和仿制药的 NHS 总支出将分别以 0.5-1.8%和 10.0-11.0%的平均复合年增长率增长。对于整个市场，2012 年的实际增长率在我们的预测范围内。