The Netherlands Cancer Institute, Department of Psychosocial Research and Epidemiology, Amsterdam, The Netherlands.
University of Twente, Department of Health Technology and Services Research, Enschede, The Netherlands.
Cancer Res Commun. 2022 Jan 27;2(1):49-57. doi: 10.1158/2767-9764.CRC-21-0031. eCollection 2022 Jan.
The high prices of innovative medicines endanger access to care worldwide. Sustainable prices need to be affordable while sufficiently incentivizing research and development (R&D) investments. A proposed solution is increased transparency. Proponents argue that price and R&D cost confidentiality are drivers of high prices. On the contrary, supporters of confidentiality claim that confidentiality enables targeted discounts which make treatments affordable; moreover, pharmaceutical companies argue that R&D investments would suffer with more transparency. Despite the political relevance, limited empirical evidence exists on the effects of transparency regulations. We contribute to fill this gap with an experiment where we replicate the EU pharmaceutical market in a laboratory setting. In a randomized controlled study, we analyzed how participants, 400 students located in four European countries, negotiated in the current system of in comparison with innovative bargaining settings where either prices only or prices and R&D costs were made transparent to buyers. We found that had no statistically significant effect on average prices or number of patients treated and made R&D investments significantly smaller (-16.86%; : 0.0024). On the other hand, reduced prices (-26%; : 0.0004) and held the number of patients constant at the level of . It produced price convergence between countries with low and high health budgets, and, despite lower prices, had no effect on R&D investments. Our findings provide novel evidence that combining price and R&D cost transparency could be an effective policy to contribute to sustainable medicine prices. See related article by Franzen et al. (Cancer Discov 2022;12:299-302).
创新药物的高价危及全球的医疗可及性。可持续的价格需要负担得起，同时也要充分激励研发（R&D）投资。一种被提议的解决方案是提高透明度。支持者认为，价格和 R&D 成本保密是高价的驱动因素。相反，保密的支持者则声称，保密可以实现有针对性的折扣，使治疗负担得起；此外，制药公司认为，提高透明度会损害 R&D 投资。尽管具有重要的政治意义，但关于透明度法规的影响，实证证据有限。我们通过在实验室环境中复制欧盟制药市场的实验来填补这一空白。在一项随机对照研究中，我们分析了 400 名来自四个欧洲国家的参与者在当前的系统中进行谈判的情况，并与创新谈判环境进行了比较，在创新谈判环境中，只向买家公开价格或价格和 R&D 成本。我们发现，仅公开价格对平均价格或治疗的患者数量没有统计学上的显著影响，并且使 R&D 投资显著减少（-16.86%；：0.0024）。另一方面，同时公开价格和 R&D 成本降低了价格（-26%；：0.0004）并保持了患者数量与不变。它导致高低卫生预算国家之间的价格趋同，并且尽管价格较低，但对 R&D 投资没有影响。我们的研究结果提供了新的证据，表明结合价格和 R&D 成本透明度可能是一项有效的政策，可以为可持续的药品价格做出贡献。见 Franzen 等人的相关文章（Cancer Discov 2022；12:299-302）。
