Should financial incentives be used to differentially reward 'me-too' and innovative drugs?

摘要: Strategies to change the existing mix of innovative and 'me-too' drugs are intended increase societal value a given investment in R&D by providing an incentive for firms invest that more likely be clinically innovative. How can financial incentives used this mix? Will strategy have its consequence or will it unintended outcome reducing rate at which population burden disease is reduced? The perspective review country such as Australia, Canada UK has universal health insurance drug reimbursement process informed economic evidence. A literature was performed views both proponents opponents strategies mechanisms they could implemented were summarized. debate based largely on hypothesized responses changes rather than empirical main point contention whether changed new molecular entities (NMEs) increases decreases total amount clinical innovation launched each year. argument presented article that, despite limited evidence, possible improve our assessment costs consequences proposed appealing theory observations about process. First, evidence supporting view changing average drug, not marginal otherwise developed, therefore misleading. Second, dynamic complex nature reduce feasibility using contractually implement strategy. Also, single unlikely impact decisions, variation per capita would make multi-jurisdiction contracts with one firm difficult implement. Third, quality lead reduced if there fewer no follow-on drugs. Finally, inefficiencies displacement finance technologies from capped budget reduces efficiency any additional potential NMEs translated disease. concludes costly implement, global uncertain direction magnitude. This case even content higher me-too designed effective. Other options effectiveness pharmaceutical should explored, including improved disinvestment technologies.