Reimbursement-Based Economics--What Is It and How Can We Use It to Inform Drug Policy Reform?

Headache. 2015 Jul-Aug:55 Suppl 4:236-47. doi: 10.1111/head.12585. Epub 2015 Jul 14.

Abstract

Background: In Ontario, approximately $3.8 billion is spent annually on publicly funded drug programs. The annual growth in Ontario Public Drug Program (OPDP) expenditure has been limited to 1.2% over the course of 3 years. Concurrently, the Ontario Drug Policy Research Network (ODPRN) was appointed to conduct drug class review research relating to formulary modernization within the OPDP. Drug class reviews by ODPRN incorporate a novel methodological technique called reimbursement-based economics, which focuses on reimbursement strategies and may be particularly relevant for policy-makers.

Objectives: To describe the reimbursement-based economics approach.

Methods: Reimbursement-based economics aims to identify the optimal reimbursement strategy for drug classes by incorporating a review of economic literature, comprehensive budget impact analyses, and consideration of cost-effectiveness. This 3-step approach is novel in its focus on the economic impact of alternate reimbursement strategies rather than individual therapies.

Results: The methods involved within the reimbursement-based approach are detailed. To facilitate the description, summary methods and findings from a recent application to formulary modernization with respect to the drug class tryptamine-based selective serotonin receptor agonists (triptans) used to treat migraine headaches are presented.

Conclusions: The application of reimbursement-based economics in drug policy reforms allows policy-makers to consider the cost-effectiveness and budget impact of different reimbursement strategies allowing consideration of the trade-off between potential cost savings vs increased access to cost-effective treatments.

Keywords: cost-effectiveness; drug reimbursement; triptan.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Drug Costs*
  • Health Policy / economics*
  • Health Policy / legislation & jurisprudence
  • Health Services Accessibility / economics
  • Humans
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / economics*
  • Migraine Disorders / epidemiology
  • Ontario / epidemiology
  • Reimbursement Mechanisms / economics*
  • Reimbursement Mechanisms / legislation & jurisprudence
  • Tryptamines / economics
  • Tryptamines / therapeutic use

Substances

  • Tryptamines