Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK,
Eur J Health Econ. 2014 May;15(4):335-40. doi: 10.1007/s10198-014-0560-1.
Current orphan drug policies are unsatisfactory when viewed from almost all perspectives. Patients find that, although therapies are available for many rare conditions, access to care is sometimes restricted. Pharmaceutical manufacturers have responded to the incentives for research embodied in orphan drug legislation, only to find that funds are not made available to pay for therapies once developed. Those funding health care find that most orphan drugs do not justify funding based on standard value for money criteria, yet that they face political problems if they fail to provide funding for therapy.
A literature review was conducted in order to determine the precise nature of the problems and to suggest potential solutions.
Current orphan drug policies are not fit for the purpose and initiatives need to be taken in the areas of (1) clarifying society's views about the priority to be given to orphan drugs, (2) revising the arrangements for pricing and reimbursement of orphan drugs, (3) defining the priorities for research into rare diseases and (4) developing 'joined up' policies to deal with these issues.
Without changes in the current policies, pharmaceutical companies will eventually cease responding to the incentives to develop orphan drugs, because they will increasingly be uncertain whether the drugs, if developed, will be reimbursed.
从几乎所有角度来看,现行的罕见病药物政策都不尽人意。患者发现,尽管有许多罕见病的治疗方法,但有时获得治疗的机会受到限制。制药商对罕见病药物立法所体现的研究激励做出了回应,却发现一旦开发出疗法,资金就无法用于支付治疗费用。那些为医疗保健提供资金的人发现,大多数罕见病药物不符合基于标准性价比标准的资金理由,但如果他们未能为治疗提供资金,就会面临政治问题。
为了确定问题的具体性质并提出潜在的解决方案,进行了文献回顾。
现行的罕见病药物政策不适合这一目的,需要在以下领域采取措施:(1)澄清社会对给予罕见病药物优先考虑的看法;(2)修订罕见病药物定价和报销安排;(3)确定罕见病研究的优先事项;(4)制定“连贯一致”的政策来解决这些问题。
如果现行政策没有变化,制药公司最终将停止对开发罕见病药物的激励做出回应,因为他们越来越不确定,如果开发出药物,这些药物是否会得到报销。