He who pays the piper...
The question of whether innovative medicines provide value for money has become increasingly fraught
In recent years there have been indications that some healthcare providers are considering a system of payments by results – the drug manufacturer would fund the cost of the treatment and the payer would reimburse the company for those patients deemed to have a favourable outcome.
Certainly payment by results is a well-known concept among the pharma r&d community – milestone payments when certain pre-agreed targets are met are commonplace along the road to market for many products. From there it is surely not too great a leap to refunding treatment costs for every extra month or year of survival or reduction in pain score or increase in mobility.
Such a system would increase the incentives for both payer and drug company to ensure that patients comply with their medication regimen.
There are some highly sophisticated packaging technologies available that would boost patient compliance significantly, but these ‘smart’ packages have – until now, at least – been priced out of the market.
Some supermarkets, notably Walmart in the US, have seized the initiative and are introducing calendarised blisterpacks for their own brand generic otc products, but the pharma industry seems to be rather slower on the uptake.
It would be interesting, for example, to see if the compulsory use of calendarised blisterpacks for the most commonly prescribed antibiotics had any effect on the rising incidence of antibiotic resistance caused by patients failing to complete their course of medication. Or whether, if the payer declared that only drugs dispensed in unit dose format be reimbursed, the number of medication errors would fall.
It seems unlikely that the pharma sector will move further down this road independently without some encouragement. Little wonder, then, that packaging designers view pharmaceuticals as the ‘last frontier’.
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