A cross-border team of attorneys provided a global analysis of pharmaceutical and healthcare products pricing and reimbursement trends, along with market access challenges from a legislative and public policy perspective.
In the Global Legal Insights “Pricing & Reimbursement 2024” chapter, the authors explore these trends across three key jurisdictions—the European Union and the United Kingdom, the United States and China. Each of these jurisdictions has adopted its own laws and policies to address affordability challenges, but common themes span the regions.
The authors note that while there has been an erosion of the “free market” reigns in the United States, even in “free market” payor markets, we continue to see conflicting incentives around drug prices and cost control.
In Europe, there is also a general theme emerging despite the national variations – Member States evaluate new therapeutic methods on their value for money before deciding whether they should be reimbursed for them to be adopted for clinical use. Significant rebates, discounts or price freezes have become recurrent health policy applied by national health systems seeking to contain healthcare expenditures.
With the change of government in the UK after the July general election, the new administration seems to recognize the need to implement a plan for procurement, adoption and diffusion of new technologies in the National Health Service by identifying which medical goods and services should be procured centrally at volume to secure the best value for the taxpayer.
State-backed Basic Medical Insurance (BMI) accounts for over 90 percent of China’s healthcare payments. In recent years, price negotiation through the National Reimbursable Drug List (NRDL) has become one of the most effective methods that the Chinese government uses to contain drug procurement costs and expand BMI coverage.
Across global jurisdictions the authors expect to see increased focus not only in the value on cost-effectiveness, but also on overall affordability. They anticipate that this dual-pronged analysis will become the new phenomenon for determining market access to new treatment modalities.
The chapter was authored by life sciences regulatory & compliance partner and head of European life sciences Lincoln Tsang, health care partner Margaux Hall and life sciences partner Katherine Wang.
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