Hospital reimbursement price cap for cancer drugs: the French experience in controlling hospital drug expenditures.

摘要: In 2005, the French Government implemented a new way of financing high-cost drugs for hospitals in order to promote innovation. Such are gathered on positive list, established by Ministry Health, with reimbursement price cap. Hospitals still negotiate pharmaceutical firms, who set their prices freely, and then charge national health insurance according consumption, without budgetary constraints, but condition good use care. They not allowed higher than this ceiling price, which is called ‘responsibility tariff’ (RT). This measure included another, larger reform, concerns hospital through allotted amounts at specific diagnosis-based level. The purpose add-on payment top funds firstly avoid heterogeneity costs per diagnostic-related group secondly an uncontrolled increase due lack interest negotiation from hospitals, as supplementary funding could reduce sensitivity. aim work was assess bargaining power firms monopoly market innovative cancer since implementation study used data Technical Agency Information (ATIH; Agence Technique de l’Information sur l’Hospitalisation) 487 were public non-profit private. analysis conducted regulated list. An index representing ratio purchase RT built 2004 2007 make ‘before-and-after’ comparison. Results showed transient decrease 2005 before alignment patented context dynamic 22.5% yearly growth rate value between 2007. able impose single-brand drugs. However, they no longer below except generic Negotiations take place upstream setting authorities firms.