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Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Godman, Brian and Malmström, Rickard E and Diogene, Eduardo and Gray, Andy and Jayathissa, Sisira and Timoney, Angela and Acurcio, Francisco and Alkan, Ali and Brzezinska, Anna and Bucsics, Anna and Campbell, Stephen M and Czeczot, Jadwiga and de Bruyn, Winnie and Eriksson, Irene and Yusof, Faridah Aryani Md and Finlayson, Alexander E and Fürst, Jurij and Garuoliene, Kristina and Guerra Júnior, Augusto and Gulbinovič, Jolanta and Jan, Saira and Joppi, Roberta and Kalaba, Marija and Magnisson, Einar and McCullagh, Laura and Miikkulainen, Kaisa and Ofierska-Sujkowska, Gabriela and Pedersen, Hanne Bak and Selke, Gisbert and Sermet, Catherine and Spillane, Susan and Supian, Azuwana and Truter, Ilse and Vlahović-Palčevski, Vera and Vien, Low Ee and Vural, Elif H and Wale, Janet and Władysiuk, Magdałene and Zeng, Wenjie and Gustafsson, Lars L (2015) Are new models needed to optimize the utilization of new medicines to sustain healthcare systems? Expert Review of Clinical Pharmacology, 8 (1). pp. 77-94. ISSN 1751-2441

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    Abstract

    Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. A number of issues and challenges were identified from the case histories. These included the low number of new medicines seen as innovative alongside increasing requested prices for their reimbursement, especially for oncology, orphan diseases, diabetes and HCV. Proposed models center on the three pillars of pre-, peri- and post-launch including critical drug evaluation, as well as multi-criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure. In conclusion, the proposed models involving all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.