Reimbursement of Pharmaceuticals: reference pricing versus health technology assessment

Mike Drummond, B Jönsson, F.F.H. Rutten, T. Stargardt

Research output: Contribution to journalArticlepeer-review


Reference pricing and health technology
assessment are policies commonly applied in order to
obtain more value for money from pharmaceuticals. This
study focussed on decisions about the initial price and
reimbursement status of innovative drugs and discussed the
consequences for market access and cost. Four countries
were studied: Germany, The Netherlands, Sweden and the
United Kingdom. These countries have operated one, or
both, of the two policies at certain points in time, sometimes
in parallel. Drugs in four groups were considered:
cholesterol-lowering agents, insulin analogues, biologic
drugs for rheumatoid arthritis and ‘‘atypical’’ drugs for
schizophrenia. Compared with HTA, reference pricing is a
relatively blunt instrument for obtaining value for money
from pharmaceuticals. Thus, its role in making reimbursement
decisions should be limited to drugs which are
therapeutically equivalent. HTA is a superior strategy for
obtaining value for money because it addresses not only
price but also the appropriate indications for the use of the
drug and the relation between additional value and additional
costs. However, given the relatively higher costs of
conducting HTAs, the most efficient approach might be a
combination of both policies.
Original languageEnglish
Pages (from-to)263-271
Number of pages9
JournalThe European Journal of Health Economics
Issue number3
Publication statusPublished - Jun 2011


  • Pharmaceuticals;

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