HealthCare Management Program, Open University of Cyprus, 33 Giannou Kranidioti Avenue 2220, P.O BOX 12794, 2252 Nicosia, Cyprus.
Cost Eff Resour Alloc. 2014 May 3;12:12. doi: 10.1186/1478-7547-12-12. eCollection 2014.
The continuing increase of pharmaceutical expenditure calls for new approaches to pricing and reimbursement of pharmaceuticals. Value based pricing of pharmaceuticals is emerging as a useful tool and possess theoretical attributes to help health system cope with rising pharmaceutical expenditure.
To assess the feasibility of introducing a value-based pricing scheme of pharmaceuticals in Cyprus and explore the integrative framework.
A probabilistic Markov chain Monte Carlo model was created to simulate progression of advanced renal cell cancer for comparison of sorafenib to standard best supportive care. Literature review was performed and efficacy data were transferred from a published landmark trial, while official pricelists and clinical guidelines from Cyprus Ministry of Health were utilised for cost calculation. Based on proposed willingness to pay threshold the maximum price of sorafenib for the indication of second line renal cell cancer was assessed.
Sorafenib value based price was found to be significantly lower compared to its current reference price.
Feasibility of Value Based Pricing is documented and pharmacoeconomic modelling can lead to robust results. Integration of value and affordability in the price are its main advantages which have to be weighed against lack of documentation for several theoretical parameters that influence outcome. Smaller countries such as Cyprus may experience adversities in establishing and sustaining essential structures for this scheme.
医药支出的持续增长要求我们采取新的方法来制定药品价格和确定药品报销。药品价值定价作为一种有用的工具正在兴起，具有帮助卫生系统应对医药支出增长的理论属性。
评估在塞浦路斯引入基于价值的药品定价方案的可行性，并探索整合框架。
我们创建了一个概率马尔可夫链蒙特卡罗模型，以模拟晚期肾细胞癌的进展，比较索拉非尼与标准最佳支持治疗的效果。进行了文献回顾，并从已发表的标志性试验中转移了疗效数据，同时利用塞浦路斯卫生部的官方价格清单和临床指南进行成本计算。基于提出的意愿支付阈值，评估了索拉非尼用于二线肾细胞癌适应证的最高价格。
与现行参考价格相比，索拉非尼的基于价值的定价明显较低。
基于价值的定价的可行性已经得到证明，药物经济学建模可以得出可靠的结果。在价格中整合价值和可负担性是其主要优势，但需要权衡影响结果的几个理论参数缺乏文件记录。像塞浦路斯这样的小国在建立和维持这一方案的基本结构方面可能会遇到困难。
