Peter J. Neumann (
Joshua T. Cohen is a research associate professor at the Center for Evaluation of Value and Risk in Health, Tufts Medical Center.
Health Aff (Millwood). 2021 Jan;40(1):53-61. doi: 10.1377/hlthaff.2020.01548. Epub 2020 Nov 19.
Prices send signals about consumer preferences and thus stimulate producers to make more of what people want. Pricing in a pandemic is complicated and fraught. The policy puzzle involves balancing lower prices to ensure access to essential medications, vaccines, and tests against the need for adequate revenue streams to provide manufacturers with incentives to make the substantial, risky investments needed to develop products in the first place. We review alternative pricing strategies (cost recovery models, monetary prizes, and advance market commitments) for coronavirus disease 2019 (COVID-19) drugs, vaccines, and diagnostics. Hybrid pricing strategies are undoubtedly needed in a pandemic, but even in a public health crisis, value-based pricing is important. Cost-effectiveness analyses can inform pricing. Ideally, analyses would be conducted from both a health system and a societal perspective. Incorporating the added value of social benefits into cost-effectiveness analyses does not mean that manufacturers should capture the entire societal benefit of a diagnostic, vaccine, or therapy. Such analyses can provide important information and help policy makers consider the full costs and benefits of products and the wide-ranging ramifications of their actions.
价格传递着消费者偏好的信号,从而刺激生产者生产更多人们想要的产品。大流行期间的定价很复杂,也充满了风险。政策难题涉及在确保获得基本药物、疫苗和检测的同时,平衡较低的价格,以确保有足够的收入来源,为制造商提供激励,使其有动力进行必要的巨额风险投资,从而首先开发产品。我们回顾了针对 2019 年冠状病毒病(COVID-19)药物、疫苗和诊断的替代定价策略(成本回收模式、货币奖励和预付款市场承诺)。混合定价策略在大流行期间无疑是必要的,但即使在公共卫生危机期间,基于价值的定价也很重要。成本效益分析可以为定价提供信息。理想情况下,应从卫生系统和社会两个角度进行分析。将社会效益的附加值纳入成本效益分析并不意味着制造商应该获得诊断、疫苗或疗法的全部社会效益。这种分析可以提供重要信息,并帮助政策制定者考虑产品的全部成本和收益,以及他们行动的广泛影响。