Pharmacoeconomics, Pricing, and Reimbursement Neil Grubert, M.A., Research Program ManagerThe Pricing and Reimbursement Environment for Neurology Drugs Neil Grubert, M.A. Abstract Introduction:
Neurological disorders will impose a growing social and fi nancial burden on the major pharmaceutical markets as the elderly population in these countries increases steadily. Governments and other payers recognize the pressing need to tackle these diseases, but they also have to control the relentless growth of healthcare expen-ditures. In an increasingly cost-conscious reimbursement climate, the pharmaceutical industry must clearly demonstrate the value of neurology drugs. Get the Answers You Need to Shape Your Strategy:
• Health technology assessment will increasingly infl uence coverage of neurology drugs in most markets in the
future. What changes are likely in Europe? How will government support for comparative effectiveness research impact the U.S. market?
• The United States has the highest overall prices of any of the major pharmaceutical markets, but prices for
neurology drugs vary widely from country to country. How do European and Japanese prices for best- selling neurology drugs compare with prices in the United States? Which drugs in this therapeutic area are more expensive in Europe and Japan than in the United States?
• European reimbursement authorities limit access to high-priced neurology drugs. Which agents are key tar- gets for reimbursement restrictions in Europe? What role do health technology assessment bodies play in regulating the use of drugs in this therapeutic area?
• The Japanese government has not employed the types of cost-containment measures used in the United States
and Europe. What is the government considering with regard to the regular price revision process? What are the prospects for long-listed drugs subject to generics competition? Decision Resources • 260 Charles Street, Waltham, Massachusetts 02453
• Tel +1.781.296.2500 • Fax +1.781.296.2550 • www.decisionresources.com •
For questions regarding this report, contact: Neil Grubert Tel +1.44.20.7612.8229 • E-mail: [email protected] For questions regarding consulting, contact: Jim McDermott Tel +1.781.296.2522 • E-mail [email protected] For questions regarding sales, service, and technical support, contact: United States: Tel +1.781.296.2500 • Fax +1.781.296.2550 | Europe: Tel +32.2.357.06.16 • Fax +32.2.351.2347 Japan: Tel +81.3.5401.2615 • Fax +81.3.5401.2617 • International price comparisons for neurology drugs: Alzheimer’s disease therapies; Parkinson’s disease
therapies; multiple sclerosis therapies; antiepileptics; migraine therapies. • Reimbursement environment in the United States, France, Germany, Italy, Spain, the United Kingdom, and Japan: general environment; Alzheimer’s disease therapies; Parkinson’s disease therapies; multiple sclero- sis therapies; antiepileptics; migraine therapies. • Outlook and implications for the pharmaceutical industry: impact of healthcare reform in the United States;
cost-containment trends; prospects for biosimilars; increasing use of health technology assessment; innovative approaches to pricing and reimbursement. Mentioned in This Report – Drugs:
• Almotriptan (Ortho-McNeil’s Axert/Almogran)
• Lamotrigine (GlaxoSmithKline’s Lamictal, generics)
• Amantadine (Novartis/Alliance Pharma/Endo’s
Symmetrel; Roche’s Mantadan; Bristol-Myers Squibb’s
• Levodopa (Roche’s Larodopa, generics)
• Levodopa-benserazide (Roche/Chugai Seiyaku’s
• Apomorphine (Britannia Pharmaceuticals’ Britaject Pen/
Madopar/Madopar CR, Modopar,Restex; Kyowa Hakko
APO-go Pen; Chiesi’s Apofi n; Aguettant/Cephalon’s
Kirin’s EC Doparl; Daiichi Sankyo’s Neodopasol;
• Azathioprine (Prometheus’s Imuran, GlaxoSmithKline’s
• Levodopa-carbidopa (Bristol-Myers Squibb/DuPont
Pharma’s Sinemet/Sinemet CR, Nacom/Nacom
• Benztropine (Ovation Pharmaceuticals’ Cogentin,
RETARD; Daiichi Sankyo’s Neodopaston; Merck/Banyu
Seiyaku’s Menesit; UCB/Schwarz Pharma’s Parcopa;
• Biperiden (Dainippon Sumitomo/Desma/Par Pharma’s
• Lisuride (Bayer Schering AG’s Dopergin/Dopergine;
• Bromocriptine (Novartis/Meda’s Parlodel, generics)
• Cabergoline (Pfi zer’s Cabaser/Cabaseril/Dostinex,
• Memantine (Merz/Grupo Grunenthal’s Axura,
Lundbeck’s Ebixa, Forest Laboratories’ Namenda )
• Carbamazepine (Novartis’s Tegretol/Tegretol XR, Shire
• Methotrexate (Dava Pharmaceuticals’ Rheumatrex, Barr
• Clobazam (Sanofi -Aventis’s Frisium/Noiafren/Urbanyl,
• Methyl-prednisolone (Pfi zer’s Solu-Medrol, other brands,
• Clonazepam (Roche’s Klonopin, generics)
• Mitoxantrone (Merck Serono/EMD Serono/Amgen/
• Cyclophosphamide (Onko’s Cytoxan, Baxter’s Endoxan,
• Mycophenolate mofetil (Roche/Aspreva/Chugai’s
• Diazepam (Roche’s Valium, Astellas’s Horizon, Takeda
Yakuhin Kogyo’s Cercine, other brands, generics)
• Naratriptan (GlaxoSmithKline‘s Amerge)
• Divalproex sodium (valproate semisodium) (Abbott/
• Natalizumab (Biogen Idec/Elan’s Tysabri)
Sanofi -Aventis’s Depakote/Depakote ER)
• Oxcarbazepine (Novartis’s Trileptal, generics)
• Donepezil (Eisai/Pfi zer’s Aricept, Bracco’s Memac)
• Pergolide (Eli Lilly’s Celance/Pharken/Nopar/Parkotil;
• Duodopa (Solvay/Orphan Europe’s Duodopa)
• Entacapone (Novartis’s Comtan; Orion’s Comtess)
• Phenytoin/phenytoin ER (Pfi zer’s Dilantin/Dilantin ER,
• Entacapone-levodopa-carbidopa (Novartis/Orion’s
• Pramipexole (Boehringer Ingelheim’s Mirapex/
• Ethosuximide (Pfi zer’s Zarontin/Suxinutin, generics)
• Etizolam (Mitsubishi Tanabe’s Depas, generics)
• Prednisone (Pfi zer’s Deltasone, other brands, generics)
• Felbamate (Meda’s Felbatol, Schering Plough/Essex’s
• Primidone (Valeant’s Mysoline, generics)
• Frovatriptan (Endo Pharmaceuticals/Menarini‘s Frova)
• Rasagiline (Teva/Lundbeck’s Agilect/Azilect)
• Gabapentin (Pfi zer’s Neurontin/Gabapen, generics)
• Rivastigmine (Novartis’s Exelon, Esteve/Biofutura/
• Galantamine (Shire Pharmaceuticals/Janssen/Ortho-
McNeil Neurologics’ Reminyl/Razadyne, generics)
• Rizatriptan (Merck & Co.‘s Maxalt)
• Glatiramer acetate (Teva’s Copaxone)
• Ropinirole (controlled release) (GlaxoSmithKline/
• Interferon-beta-1a (intramuscular) (Biogen Idec’s
• Ropinirole (immediate release) (GlaxoSmithKline’s
• Interferon-beta-1a (subcutaneous) (Merck Serono/EMD
• Rotigotine (UCB/Schwarz Pharma’s Neupro)
• Interferon-beta-1b (Bayer Schering/Bayer HealthCare’s
Betaseron/Betaferon, Novartis’s Extavia)
• Selegiline (Somerset Pharmaceuticals/Orion’s Eldepryl, Movergan; HRA Pharma’s Deprenyl; Chiesi’s Egibren/Seledat/Jumex
Meda’s Plurimen/Antiparkin; Bristol-Myers Squibb’s EMSAM; Fujimoto Seiyaku’s FP; generics)
• Selegiline (fast-dissolving) (Valeant/Cephalon’s Zelapar/Xilopar/Otrasel)• Sultiame (Bayer/Desitin/Idis Pharma/Kyowa Pharmaceutical Industry’s Ospolot, generics)• Sumatriptan (GlaxoSmithKline‘s Imigran/Imitrex)• Sumatriptan/naproxen sodium (GlaxoSmithKline‘s Treximet)• Talipexole (Boehringer Ingelheim’s Domin)• Tiagabine (Cephalon’s Gabitril)• Tolcapone (Valeant Pharma/Roche’s Tasmar)• Topiramate (Ortho-McNeil/Janssen-Cilag’s Topamax, Kyowa Hakko Kirin’s Topina) • Trihexyphenidyl (Wyeth Pharmaceuticals/Sanofi -Aventis/Teopharma’s Artane, generics)• Valproic acid (Abbott’s Depakene, Sanofi -Aventis’s Epilim/Depakine, Kyowa Hakko Kirin’s Depakene, generics)• Vigabatrin (Sanofi -Aventis’s Sabril, generics)• Zolmitriptan (AstraZeneca‘s Zomig/Zomigoro/AscoTop)• Zonisamide (Dainippon Sumitomo’s Excegran, Eisai’s Zonegran)
Look for relevant insight within these Spectrum series and related Spectrum reports: Pharmacoeconomics, Pricing, and Reimbursement examines a broad range of issues affecting the pharmaceutical industry, including prescribing trends, company pricing strategies, payers’ reimbursement policies, the growing use of pharmacoeconomics and health technology assessment, and important changes in national health care systems. These reports provide timely insights into the challenges that the pharmaceutical industry faces in a volatile pricing and reimbursement environment. Quarterly Reviews of Pricing and Reimbursement News provide timely analysis of key developments in pharmaceutical pricing and reimbursement in the United States, the European Union, France, Germany, Italy, Spain, the United Kingdom, and Japan. These reports will help you to keep abreast of the latest changes—and the outlook—in these key markets.
The Pharmaceutical Pricing Chartbook Series examines pricing trends for the world’s best-selling branded drugs and for molecules that have been subject to generics competition in recent years. The reports’ wealth of data and analysis on pricing differentials in seven major markets will be invaluable to companies that need to understand detailed pricing trends in key markets. Pharmaceutical Industry Dynamics evaluates the evolving landscape for pharmaceutical and biotechnology companies, explores new business opportunities, and examines strategies to help companies in their decision-making processes. We cover industry-wide trends and events and assess the attendant challenges and opportunities they present. Our analysis and expert advice are invaluable for your decisions about future business strategy and the development of new business models. Therapeutic Markets – Opportunities and Pipeline Dynamics provides comprehensive review and analysis of a wide range of drug classes and therapeutic indications, including major disease states, orphan diseases, and niche markets, with an emphasis on key established and emerging players. The insights contained in these reports will help you understand specifi c marketplaces and shape your strategy to maximize the commercial potential of your pipeline.
Originally published as: Lankester, F., Mätz-Rensing, K., Kiyang, J., Jensen, S.A., Weiss, S., Leendertz, F.H. Fatal ulcerative colitis in a western lowland gorilla (gorilla gorilla gorilla) (2008) Journal of Medical Primatology, 37 (6), pp. 297-302. DOI: 10.1111/j.1600-0684.2008.00287.x The definitive version is Fatal ulcerative colitis in a western lowland gorilla (gorilla gori