Improvement of modern approaches to reference pricing for insulin preparations

Abstract

Diabetes mellitus is a serious incurable disease that requires special from society and the government due to its high prevalence, severity of complications and the high cost of treatment, diagnosis and self-monitoring. Therefore, the development of an effective system of price regulation and cost recovery to ensure maximum coverage is an actual problem of modernity. The aim of the work is to substantiate the approaches to reference pricing for insulin preparations. The object of the research is scientific publications on the treatment of diabetes mellitus, reference pricing and reimbursement, official websites of authorized bodies of reference countries, statistics, price indicators, legal acts. The research was conducted using methods of analysis, systematization and generalization, mathematical and statistical calculations. The study of the state of pharmaceutical supply of patients with type I diabetes in 2015–2019 allowed us to identify the main trends – changes in the structure and dynamics of insulin consumption in the hospital and retail (pharmacy) segment in connection with the introduction and implementation of a pilot project to reimburse their cost. Currently in Ukraine, 77 trade names of insulin preparations are subject to reimbursement, the vast majority of them (69%) – foreign production. External monitoring of ex-factory prices for 107 insulin preparations (26 reference groups) was carried out in 13 countries. It has been established that most domestically produced drugs have prices lower by 2.5–14% than the average in reference countries. Moreover, in many countries (Hungary, Romania, Slovakia, Greece, Poland, the Czech Republic), insulin prices are lower than those declared in Ukraine. This must be taken into account when choosing reference countries. The analysis shows that in most European countries, external analysis analyzes the indicators of wholesale prices in more than 10 countries. In order to develop the optimal methodology of setting reference prices, we carried out price calculations for different approaches. The best option is to determine the minimum price or the average of the three lowest. This approach is consistent with the experience of European countries, and most importantly – it takes into account the significant limited budget funds in Ukraine and the low solvency of patients. A predictive calculation allows estimating influence of the offered model on prices and proves its efficiency in reducing the price of imported preparations. Based on the results of a comprehensive study, a generalized model of reference pricing has been developed, which is substantiated by calculations and is optimal for modern conditions.

Keywords

• reference pricing
• insulin preparations
• pilot project
• drug availability