Pharmaceutical Pricing

Content

• Chapter 1: Pricing and the Pharmaceutical Market
  • The definition of price
  • The functions of price
  • The marketing mix
  • The product
  • Case study: Lilly's proactive strategy for patent expiry The place
  • The rise of the Internet as a sales channel 8
  • The price Promotion
  • The effect of price on the other elements of the marketing mix: the product
  • Therapeutic efficacy
  • Therapeutic enhancements
  • Case study: drug delivery system strategies
  • The brand
  • Pricing objectives
  • Target return on investment
  • Market share
  • Meeting competition
  • Profit maximisation
  • Stabilisation of prices
  • Pricing strategies to meet objectives
  • Skimming
  • Prestige pricing
  • Penetration pricing
  • Extinction pricing
  • Case study: Losec price reduction in Denmark
  • List prices and contract prices
  • Case study: US states launch innovative pooled drug purchasing programme
  • Pricing freedom
  • Pricing and external issues
  • Pricing and government policy shifts
  • Case study: changes to Russian taxation system impact on pharmaceutical industry profits
  • Case study: Philippines government pharmaceutical policy affects industr
  • revenues
  • Currency fluctuations
  • Case study: Indian pharmaceutical companies deal with falls in the US dollar
  • The EU
  • EU expansion and the pharmaceutical market
  • The euro
  • The euro and the pharmaceutical industry
  • The rise of the euro
  • Parallel importation
  • The euro and parallel trade
  • Case study: a single European pricing scheme for Crixivan
  • EU expansion and pharmaceutical pricing
  • The European Economic Area (EEA)
  • EU enlargement and the EEA
  • Pricing issues in the US
  • Pricing issues in Europe and Japan
  • Pharmacoeconomics
  • The rise of pharmacoeconomics and health economics
  • Case study: treatments for congestive heart failure
  • Case study: Neoral and Sandimmun
  • Case study: cheaper diagnostic test for HIV
  • The economic costs of disease
  • Case study: the impact of ageing on healthcare resource allocation
  • Case study: pharmacoeconomics and drug prescribing for children in Italy
  • Case study: the financial consequences of inappropriate antibiotic prescribing
  • Case study: rising drug costs restrict uptake of malaria therapies in developing countries
• Chapter 2: Pricing through the Pharmaceutical Product Life Cycle
  • The life cycle of a pharmaceutical
  • The classical pharmaceutical life cycle
  • Changes to the classic pharmaceutical product life cycle
  • Case study: Viagra
  • Case study: Levitra
  • Case study: Cialis
  • Brand development
  • Rx-to-OTC switching
  • Case study: the UK's smoking cessation market Time to market
  • Cost of R&D
  • Global roll-out
  • New product pricing
  • Customers
  • The company
  • Competitors
  • Case study: Biogen's Avonex
  • The decline of exclusivity for 'pioneer' pharmaceutical products
  • Manufacturing costs of a product
  • Case study: Genzyme's Ceredase and Cerezyme
• Chapter 3: Parallel Trade
  • The view of pharmaceutical manufacturers
  • The view of parallel traders
  • Legalities of parallel trade
  • Case study: Ferring v. Eurim-Pharm
  • Case study: Leo Pharma v. Orifarm
  • Repackaging and re-labelling of products
  • Case study: Upjohn sale of Dalacin in Denmark
  • International parallel trade
  • Case study: parallel trade in Kenya
  • Protection of products from parallel importation
  • European hospitals and parallel importers
  • Governments and other purchasers
  • Competitors
  • Pricing differentials
  • Differentials created by price discounts
  • Price differentials resulting from variations in pricing regulations
  • Creation of post-patent price differentials
  • Pricing within a single price band
• Chapter 4: Rx-to-OTC Switching and Pricing
  • The marketing mix for switched drugs
  • Product
  • Place
  • Price
  • Promotion
  • Case study: Claritin pricing
  • The implications of OTC status
  • Strong branding
  • Effects of patent expiry
• Chapter 5: Generic Drugs
  • The popularity of generics
  • Encouraging the use of generics
  • Wholesalers in the EU
  • The potential for biogenerics
  • Obstacles to biogenerics
  • Facing up to generic competition
  • Case study: Augmentin loses US patent
  • Case study: Viagra patent legal battle
  • Future patent battles
  • Case study: biogeneric competition to Epogen
  • Case study: patent fears overshadow Sanofi-Synthlabo and Aventis tie-up
  • Strategies to extend effective patent life
  • Case study: 6-month exclusivity for Diflucan
  • New formulations
• Chapter 6: Company and Customer Interactions
  • Clinicians
  • Case study: resistance to OTC Zocor in the UK
  • Patients
  • Case study: patient protests at halting of clinical trials for an anti-viral compound
  • The traditional supplier-customer frameworkClinician pressure
  • Case study: US doctors prescribe expensive high blood pressure
  • medications
  • Case study: poor awareness of drug prices in Canada
  • Company strategies
  • Disease management packages
  • Case study: Novo Nordisk and diabetes treatments
  • Collaborations with healthcare providers
  • Case study: the development of new antibiotics
  • 'Bundling' Internet mail order
  • Case study: Internet trade in the US
  • Tendering
  • Case study: cancer trials
  • Consumer views on pricing
  • Case study: international consumer survey on pharmaceutical prices
  • Case study: AIDS drug price increase angers US patient group
  • Case study: Public Citizen group advocacy in the US
  • Price fixing
  • Case study: Lupron price-fixing allegations in the US
  • Case study: generic antibiotic price fixing in the UK
  • EU vitamin price-fixing scandal
  • Case study: generic anti-anxiety drug price fixing in the US
  • Hospital negotiation of pharmaceutical prices
  • Price analysis
  • Case study: parallel importation by Belgian hospitals
  • Case study: parallel trade of anti-retroviral drugs
  • Government
  • Direct price controls
  • Positive lists
  • Negative lists
  • Reference pricing
  • Reimbursement levels
  • Dealing with wholesalers and retailers
  • Government interventions in the pharmaceutical market and the view of the industry
  • Case study: German pharmaceutical industry resists government cost containment policies
  • Intellectual property
  • Patent piracy
  • Case study: IP and the Chinese pharmaceutical market
  • Case study: IP and the Latin American pharmaceutical market
  • Case study: the Indian pharmaceutical industry
  • Price controls in various countries
  • Buyers in the US
  • Pricing/volume agreements
  • Profit control in the UK
• Chapter 7: Pharmaceutical Pricing in North America
  • The US
  • The US healthcare system
  • The US pharmaceutical market
  • US drug spending
  • International price comparisons
  • The reaction of the industry
  • Determination of drug prices by manufacturers
  • Average wholesale price and average sales price
  • Case study: Medicare reform and oncology drug reimbursement
  • Cost containment
  • Generics
  • A move towards pricing control measures?
  • Canada
  • The Patented Medicine Prices Review Board
  • Case study: the FDA and industry resist cross-border trade in pharmaceuticals
• Chapter 8: Phamaceutical Pricing in Japan
  • Cost containment
  • Drug pricing in Japan
• Chapter 9: Pharmaceutical Spending Controls in Europe
  • The UK
  • The Pharmaceutical Price Regulation Scheme (PPRS)
  • The National Institute for Clinical Excellence (NICE)
  • The prospects for 'Euro-NICE'
  • France
  • Healthcare spending
  • Revisions to the pricing system
  • Germany
  • Healthcare reforms
  • Fixed pricing schemes
  • Viewpoint of the pharmaceutical industry
  • Case study: cross-border purchase of pharmaceuticals in Poland
  • Spain
  • Pricing
  • Pharmaceutical demand
  • Government incentives to industry
  • Italy
  • Pricing system
  • Case study: investigation of price fixing in Italy
• Chapter 10: Pharmaceutical Pricing and the Developing World
  • Case study: adverse UK media coverage of the pharmaceutical industry
  • The concept of compulsory licensing
  • The grounds for using a compulsory licence
  • Case study: compulsory licensing in North America
  • Africa and the AIDS crisis
  • South Africa and HIV drug pricing
  • Brazil and HIV drug pricing
  • The future of compulsory licensing
  • Case study: diversion of anti-retroviral drugs destined for Africa
  • Anti-diversion tactics
  • Funding for AIDS drugs in the developing world
  • The Mdecins Sans Frontires campaign for access to essential medicines
• List Of Figures
  • Figure 1.1 Breakdown of retail medicine price in Europe 6
  • Figure 1.2 Internet usage statistics (2004) 9
  • Figure 1.3 Online Canadian pharmacy cost for Prozac and generic fluoxetine (10 mg 100) in 2004
  • Figure 1.4 Clinical development projects employing drug delivery technologies 12
  • Figure 1.5 Periods of market exclusivity between the launch of an innovative medicine and competitor products
  • Figure 1.6 Currency fluctuations: monthly exchange rate of Japanese yen to US$1 during 2003 20
  • Figure 1.7 Currency fluctuation; monthly exchange rate for US$ to 1 during 2003
  • Figure 1.8 Composition of international reserves
  • Figure 1.9 Spend on medicines as a percentage of GDP in various countries 28
  • Figure 1.10 Neoral costs (1998)
  • Figure 1.11 Annual economic burden of major diseases in the US
  • Figure 1.12 European hospital costs for osteoporosis-related hip fracture
  • Figure 1.13 Population estimates and projections (1990 and 2020): percentage of the population aged 65 years or over
  • Figure 2.1 Online unit cost for Viagra 100 mg tablets in North American pharmacies (2004)
  • Figure 2.2 Online US pharmacy cost for Levitra 20 mg (2004)
  • Figure 2.3 Online US pharmacy cost for Cialis 10 mg (2004)
  • Figure 3.1 Financial effect on the German pharmaceutical industry of government intervention since 1999
  • Figure 3.2 UK versus Europe: HIV drug prices (1999) 56
  • Figure 3.3 Bilateral comparisons of ex-manufacturer prices for France, Spain and Italy versus the UK
  • Figure 3.4 Bilateral comparisons of ex-manufacturer prices for the US versus the UK (UK = 100%)
  • Figure 4.1 Online unit cost for Claritin 10 mg tablets in North American pharmacies (2004)
  • Figure 5.1 Development of the French generics market (by value)
  • Figure 5.2 Breakdown of sales by distribution channel in France (2002)
  • Figure 5.3 Sales of Viagra
  • Figure 5.4 Worldwide sales of Epogen
  • Figure 5.5 Sales of Diflucan
  • Figure 6.1 Number of Internet users in Europe (2004)
  • Figure 6.2 Online unit cost for Celebrex 200 mg in North American pharmacies (2004)
  • Figure 6.3 Public Citizen cost estimates of a 30-day supply of selected CNS drugs
  • Figure 6.4 Public Citizen estimates of long-term 'excess costs' for CNS drugs in the US compared with the average cost in other countries
  • Figure 6.5 Parallel importation: Zerit
  • Figure 6.6 Parallel importation: Inverase
  • Figure 7.1 Online unit cost for Prozac 10 mg tablets in US pharmacies (2004)
  • Figure 7.2 Average country prescription drug prices as a proportion of corresponding US prices
  • Figure 7.3 Average annual percentage change, patented drug prices (1996-2001)
  • Figure 8.1 Population projections for 2000 and 2020 - proportion of the population aged 65 years or over
  • Figure 8.2 Number of NHI-listed pharmaceuticals in Japan
  • Figure 9.1 R&D expenditure by pharmaceutical companies in the US and Europe
  • Figure 9.2 UK family expenditure survey: daily expenditure (2000/01)
  • Figure 9.3 Estimated UK healthcare savings for selected diseases through reduced use of hospital beds since 1957
  • Figure 9.4 Estimated UK healthcare savings for selected diseases through reduced use of hospital beds since 1957
  • Figure 9.5 Sales of pharmaceuticals in France (2002)
  • Figure 9.6 The financing of statutory health insurance in Germany
  • Figure 10.1 Global status of the HIV/AIDS epidemic
  • Figure 10.2 National HIV prevalence rates in Africa (2003)
• List of Tables
  • Table 1.1 Expansion of the EU
  • Table 1.2 Some parallel import options offered to European hospitals in 1997
  • Table 1.3 The core features of a pharmaceutical
  • Table 1.4 Evaluating the costs of disease
  • Table 2.1 Summary of pharmaceutical company options to counter parallel importing
  • Table 4.1 Useful attributes for OTC drugs
  • Table 4.2 Potential audiences for OTC promotion
  • Table 10.1 Key points of the TRIPS agreement
  • Table 10.2 International approaches to compulsory licensing (as of 2004)
  • Table 10.3 Overview of MSF proposals to improve access to medicines in developing regions