Pricing and Reimbursement Policies Worldwide

In the world of pharmaceuticals, pricing and reimbursement policies play a critical role in ensuring that drugs are accessible to those who need them. However, the objective of these policies is not necessarily to control costs - rather, it is to ensure that drug prices and reimbursement levels reflect their true value and remain affordable to patients and healthcare systems.
Direct pricing controls, including regulation of prices, external reference pricing, tendering, and health technology assessment, are measures that can be used to determine target prices for drugs. Reimbursement policies, such as internal reference pricing and tiered reimbursement, can also be applied.
In the European Union, measures like direct pricing controls, including pricing, price limits, and price reductions, are widely used, as many European countries have the ability to act as large, single buyers in the market. In the United States, however, direct pricing controls are less frequently used, as the presence of numerous insurance companies makes a combined approach of direct control and market competition more appealing.
Evidence from Germany and the Netherlands suggests that tendering can result in substantial price reductions of 80-90% for drug orders. Tendering, which typically considers only price as a deciding factor, assumes that product quality is not an issue when selecting among similar drugs.
While pricing and reimbursement policies may vary by country, the overall objective remains the same: to ensure that patients have access to drugs that are priced appropriately and remain affordable to healthcare systems. As such, it is important for policymakers to consider a range of options when designing pricing and reimbursement policies, including direct pricing controls and tendering.