Lhoste F
Université Paris Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France; CEPS, ministère des affaires sociales et de la santé, 14, avenue Duquesne, 75350 Paris 07 SP, France.
Ann Pharm Fr. 2013 Sep;71(5):279-84. doi: 10.1016/j.pharma.2013.08.002. Epub 2013 Sep 12.
In recent decades, the pharmaceutical industry as built a high level of confidence thanks to innovative medicines that improve both duration and quality of life. Some recent scandals have however discredited this industry, now suspected of cheating or bribery. Even the scientific progresses are challenged on the ground of possible conflicts of interests and value uncertainty. This situation is deleterious. Simultaneously the economic crisis exacerbates the payers' expectations in terms of clinical value and value/price ratio. It also stimulates the demand for outcomes in real life. This induces a new economic approach for the market access of highly expensive reimbursable drugs. It consists in paying only for drugs actually proven effective in terms of actual outcomes, with a full or partial refund of the payer in case of failure, according to accurate and simple criteria in so called "performance agreement". Confidence is restored accordingly.
近几十年来，制药行业凭借创新药物建立了高度的信心，这些药物改善了人们的生活时长和质量。然而，最近的一些丑闻使该行业声誉受损，如今被怀疑存在欺诈或贿赂行为。甚至科学进展也因可能的利益冲突和价值不确定性而受到质疑。这种情况是有害的。与此同时，经济危机加剧了支付方对临床价值和性价比的期望。它还刺激了对现实生活中治疗效果的需求。这催生了一种针对高价可报销药物市场准入的新经济模式。该模式是仅为实际被证明在实际治疗效果方面有效的药物付费，若治疗失败，根据所谓“绩效协议”中的准确且简单的标准，支付方将获得全部或部分退款。信心也因此得以恢复。
