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Title: Reimbursement-based economics - What is it and how can we use it to inform drug policy reform?
Authors: Coyle, D
Lee, KM
Mamdani, M
Sabarre, KA
Tingley, K
Keywords: Cost-effectiveness;Drug reimbursement;Triptan
Issue Date: 2015
Publisher: Wiley
Citation: Headache: The Journal of Head and Face Pain, 55: 236–247, (2015)
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.
ISSN: 1526-4610
Appears in Collections:Institute for the Environment

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