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TMCNet:  Managed Markets Groups Look to Europe to Anticipate Future US Reimbursement Policies

[January 10, 2013]

Managed Markets Groups Look to Europe to Anticipate Future US Reimbursement Policies

RESEARCH TRIANGLE PARK, N.C. --(Business Wire)--

The gap between European and US reimbursement may be narrowing, according to recent analysis by pharmaceutical intelligence firm Cutting Edge Information.

US managed market payers are generally more flexible than those in Europe. While European countries demand steep discounts for products to qualify for formulary, the US has steered clear of these types of policies.

Cutting Edge Information's recent study, "US Managed Markets: Driving Commercial Success through Outcomes-Based Reimbursement," found that US managed markets teams should pay careful attention to global trends. Aggressive pricing is on the rise in Europe. The UK's government price control agency, NICE, reduced drug prices through value-based pricing and risk-sharing agreements. Germany's new AMNOG law implements similarly rigorous value-based pricing.

"Many European countries are becoming even more aggressive at controlling prices," said Michelle Vitko, senior research analyst at CuttingEdge Information. "As the gap between prices in the US and Europe widens, the likelihood that Medicare will clamp down on those prices increases."


Some companies, seeing how low prices in one country can lead to lower prices everywhere, have ceased marketing new products in some European countries, including Greece and even Germany. So far, the US has not followed this same trend. Even now, Medicare and other US payers cannot look to findings from the Patient Centered Outcomes Research Institute (PCORI) to bargain for lower prices or mandate that physicians prescribe certain treatments. However, PCORI is in a position to informally exert control over the US market. If this agency positions itself to influence physician behavior, drug makers may find that market access and premium pharmaceutical pricing are increasingly more difficult to achieve.

"US Managed Markets: Driving Commercial Success through Outcomes-Based Reimbursement" (http://www.cuttingedgeinfo.com/research/market-access/strengthen-payer-relationships/) provides best practices and benchmarks to enable managed markets teams to perform in the current US reimbursement environment. The study helps companies:

  • Manage pricing pressures and the narrowing gap between US and European reimbursement policies.
  • Position and prepare account managers to meet with influential payers.
  • Compare different industry takes on the US reimbursement landscape.

For more information about managed markets and market access benchmarking, contact Cassie Demeter at 919-403-6583.


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