We considered a healthcare system with government-negotiated drug prices based on the value of drugs. We assumed a drug with 2 indications and 1 relevant comparator for each indication. The value of the drug was uniformly distributed among the patients of each indication in the base case. We also considered alternative scenarios with exponentially and Pareto distributed drug values. Numerical simulations were conducted to explore potential settings where ISVBP was welfare-improving for patients compared with single pricing.
The theoretical analysis showed that the consumer surplus change was strictly non-positive from single pricing to ISVBP. Therefore, it was not welfare-improving for patients in the settings of interest. Numerical simulations confirmed this result across various scenarios of value distributions.
This study provides insights into the patient welfare implications of ISVBP for multi-indication drugs. We did not identify conditions under which ISVBP can enhance overall patient well-being, suggesting that it should be implemented cautiously. Future research should examine dynamic welfare implications related to innovation incentives because they may significantly affect population health in the future.
方法:我们考虑了一种医疗保健系统,该系统具有基于药物价值的政府谈判的药物价格。我们假设一种药物具有两个适应症和每个适应症的一个相关比较器。在基础病例中,药物的价值在每个适应症的患者中均匀分布。我们还考虑了具有指数和帕累托分布药物值的替代方案。进行了数值模拟,以探索与单一定价相比,ISVBP改善患者福利的潜在设置。
结果:理论分析表明,从单一定价到ISVBP,消费者剩余变化严格为非正。因此,在感兴趣的环境中,这并不是改善患者的福利。数值模拟在各种价值分布情况下证实了这一结果。
结论:本研究提供了ISVBP对多适应症药物患者福利影响的见解。我们没有确定ISVBP可以增强患者整体健康的条件,建议谨慎实施。未来的研究应该研究与创新激励相关的动态福利影响,因为它们可能会在未来显著影响人口健康。