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市場調査レポート
世界の主要国における癌治療薬の政治・償還関連環境：主要動向
Key Trends in the Political and Reimbursement Environment for Cancer Drugs
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Abstract
Introduction
Cancer therapies make up one of the fastest-growing therapeutic areas in the
global pharmaceutical market. IMS Health expects global sales of cancer
therapies to more than double in just four years, exceeding $65 billion in
2010. Not surprisingly, the pharmaceutical industry is eager to tap the
potential of this market. A critical factor in this growth, in both the United
States and the European market, is the ever-evolving reimbursement
environment-and the political trends that infl uence it.
Get the Answers You Need to Shape Your Strategy
- Oncology drugs form one of the largest therapeutic areas of the global
pharmaceutical market, with worldwide sales of almost $30 billion in 2006.
What factors account for the success of this fast-growing market? How is
the pharmaceutical industry responding to this growth?
- Increasingly restrictive reimbursement policies will continue to impose
strict cost controls on cancer therapies. How will the U.S. Medicare system
manage its funding policies? What changes are in store for cancer therapy
reimbursements by commercial insurers? How will the new funding program in
France affect its high rate of spending on cancer drugs? How will reform
measures in Germany affect its reference pricing system. What changes are
included in Italy' s new national health system? Will the U.K.' s new Cancer
Reform Strategy affect spending on cancer drugs?
- The global market for oncology drugs will continue to grow vigorously in
the coming years. Are the industry' s pricing strategies expected to change
in the worldwide market? What strategies will pharmaceutical companies
undertake to expedite the launch of new drugs in Europe?
Scope
- The fi ght against cancer is one of the highest healthcare priorities
in all advanced economies: government funding systems; worldwide public
and private reimbursement programs; payment policies for innovative cancer
therapies.
- U.S. and European government insurance systems are all under pressure
to rein in healthcare costs: reimbursement for cancer therapies is a
target for cost cutting; offi ce-based cancer treatments create payment
challenges for physicians; pharmaceutical companies need to establish an
infrastructure for conducting price negotiations with payers.
- Health technology assessment (HTA) now infl uences a wide span of
product life cycles: earlystage R&D affected by the demands of HTA;
evidence of clinical effectiveness needed to defend a drug against the threat
of price cuts.
- Illustrated fi gures: Percentages of private and Medicare plans
that place restrictions on the use of select targeted cancer therapies.
Table of Contents
- Executive Summary
- Strategic Considerations
- Stakeholder Implications
- Introduction
- United States
- Changes to Medicare Part D Coverage of Oncology Drugs
- Impact of Changes to Medicare Part B Reimbursement
- Reductions in Medicare Hospital Outpatient Reimbursement
- Reimbursement Changes in the Private Sector
- Infl uence of Physician Reimbursement on Prescribing Behavior
- Coverage of Targeted Therapies
- Cost-Containment Strategies
- Patient Access to Innovative Therapies
- Courts Reject Calls for Right of Access to Experimental Drugs
- FDA Amendments Act
- France
- Strong Growth in Spending on Oncology Drugs
- Flexible Funding Arrangements for Innovative Drugs
- Promoting Good Use of Cancer Therapies
- Germany
- Prospect of Health Economic Evaluation and Reimbursement Limits for New
Therapies
- Interaction Between Hospitals and Primary Care
- Disease Management Programs
- Off-Label Prescribing
- Italy
- Hospital Reimbursement
- Financial Constraints
- Spain
- Regional Variations in the Use of Innovative Therapies
- National Cancer Strategy
- Future Emphasis on Health Technology Assessment of New Drugs
- United Kingdom
- Cancer Reform Strategy
- NICE' s Impact on U.K. Oncology
- Diffi culties of Combining Privately and Publicly Funded Treatment
- Government Plans to Replace the Pharmaceutical Price Regulation Scheme
- Outlook and Implications for the Pharmaceutical Industry
Tables
- 1. Regional Variations in the Use of Select Targeted Cancer Therapies in
Spain
Figures
- 1. U.S. Cancer Patients' Principal Sources of Health Insurance Coverage
- 2. Coverage of Select Targeted Cancer Therapies by Private Health Plan
- 3. Coverage of Select Targeted Cancer Therapies by Medicare Plans
- 4. Percentage of Private and Medicare Plans That Impose Prior
Authorization on Select Targeted Cancer Therapies
- 5. Percentage of Private and Medicare Plans That Monitor Patient Response
to Select Targeted Cancer Therapies
- 6. Percentage of Private and Medicare Plans That Impose Quantity Limits on
Select Targeted Cancer Therapies
- 7. Percentage of Private and Medicare Plans That Require Patients to
Obtain Select Targeted Cancer Therapies from Specialty Pharmacies
- 8. Percentage of Private and Medicare Plans That Impose No Cost Controls
on the Use of Select Targeted Cancer Therapies
Sidebar
- Brown Bagging on the Increase in the United States
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