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Browsing by Subject "viitehintajärjestelmä"

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  • Epilepsialääkkeet lääkevaihdossa ja viitehintajärjestelmässä 
    Rissanen, Johanna (2020)
    Lääkevaihto ja sitä täydentävä viitehintajärjestelmä ovat laskeneet lääkekustannuksia Suomessa. Epilepsialääkkeet eivät ole aiemmin kuuluneet lääkevaihdon piiriin, sillä epilepsian hoidossa eri valmisteet eivät välttämättä ole terapeuttisesti tarpeeksi samanarvoisia, ja pienikin muutos hoitotasapainossa voi altistaa epilepsiakohtauksille. Nykyisin epilepsialääkkeitä käytetään kuitenkin usein muihinkin käyttöaiheisiin, kuten psykiatrisiin sairauksiin ja kivun hoitoon. Vuonna 2017 lääkekorvausjärjestelmään tehtiin säästötoimenpiteitä, joiden yhteydessä epilepsialääkkeet sisällytettiin lääkevaihdon piiriin muissa käyttöaiheissa kuin epilepsian hoidossa. Lisäksi otettiin käyttöön poikkeava viitehintaryhmä, joka koski epilepsialääkkeistä pregabaliinia neuropaattisen kivun käyttöaiheessa. Tutkimuksen tavoitteena oli tarkastella epilepsialääkkeiden (pregabaliinin, gabapentiinin, topiramaatin, lamotrigiinin ja valproiinihapon) vaihtamista sekä hintojen kehitystä lääkevaihtoon ja viitehintajärjestelmään sisällyttämisen jälkeen vuoden 2017 alusta vuoden 2019 puoliväliin. Lisäksi tarkasteltiin näiden lääkeaineiden kustannusten, korvausmenojen sekä käyttäjä- ja reseptimäärien kehitystä. Aineistona käytettiin Kansaneläkelaitoksen reseptirekisteriin pohjautuvia tilastoja epilepsialääkkeiden lääkeostoista sekä lääkkeiden hintalautakunnan päätöksiä epilepsialääkkeiden viitehintaryhmistä ja viitehinnoista. Epilepsialääkkeiden vaihtaminen yleistyi tarkastelujakson aikana kaikilla lääkevaihdon piirissä olleilla viidellä lääkeaineella, ja vaihtokieltojen osuus resepteistä laski useimmilla lääkeaineista. Viitehinnat laskivat useimmissa tarkastelluista viitehintaryhmistä, mutta lähes yhtä usein viitehinta ei muuttunut. Viitehinnat laskivat enemmän viitehintaryhmissä, joissa oli useampia vaihtokelpoisia valmisteita. Lääkevaihdon ensimmäisenä vuonna 2017 lääkevaihtoon kuuluvien epilepsialääkkeiden kustannukset ja korvausmenot pääosin laskivat, vaikka lääkkeiden käyttö ei vähentynyt. Lääkevaihdon toisena vuonna kustannukset eivät juuri laskeneet. Pregabaliinin poikkeavan viitehintaryhmän vuoksi vaihtamatta jääneet reseptit aiheuttivat merkittävän osan lääkevaihtoon kuuluvien epilepsialääkkeiden kustannuksista. Pregabaliinille jäi siten todennäköisesti yhä säästöpotentiaalia poikkeavan viitehintaryhmän voimassaolon päätyttyä vuoden 2019 heinäkuussa, mitä on syytä tarkastella jatkotutkimuksissa.
  • Lääkkeiden rinnakkaismaahantuonnin ja viitehintajärjestelmän vaikutukset suoratuonti- ja rinnakkaismaahantuontivalmisteiden hintojen sekä viitehintojen kehitykseen Suomessa 
    Helle, Emilia (2021)
    Background. Parallel importing of pharmaceuticals has potential to generate significant savings but results of previous theoretical and empirical studies on the consequences of parallel importing and its ability to generate competition have been contradictory. Little research on the effects of parallel importing has been conducted in Finland. In April 2017, the reference price system in Finland was extended to also cover substitution groups determined on the basis of parallel imports. The aim of the reform was to increase competition between direct and parallel imports and thus to generate savings in reimbursement costs. However, the impact of the reform has not yet been significantly studied. Aim. The aim of this study was to examine the effects of parallel importing and the expansion of the reference price system on the price development of direct and parallel imported medicines and reference prices. The purpose was to investigate in general the price development of products and reference prices in the period following the expansion of reference price system, to examine the importance of how long a reference group was involved in the system on price development, to examine the impact of the extension of the reference price system and the market entry of a competing parallel import in particular on prices of direct imported products and to examine the importance of the number of parallel imports competing with the direct imported product on price development. Methods. Reference price decisions and lists of prices of reimbursable medicinal products were used as research material. The data was found on the website of the Pharmaceuticals Pricing Board. Quarterly price data on the prices of products belonging to the reference price groups determined on the basis of parallel imports was extracted from the data. Price data was examined from January 2016 to October 2019. Price development was monitored as percentage changes on a quarterly and annual basis. The effect of extension of the reference price system and the entry of a competing parallel import was examined using a sort of before-after set-up by comparing the price development of products before the change to the price development of products after the change. Regression analysis was used to assess the statistical significance of the variables explaining price development of products. Results and conclusions. During the period, the prices of direct and parallel imports and the reference prices decreased in most of the reference price groups. Price increases amongst the groups were very rare. Based on price development and regression analyzes, both the expansion of the reference price system and the market entry of a competing parallel import significantly reduced the prices of direct imports. However, the time that the reference group was involved in the reference price system or the number of parallel imports competing with the direct import did not have a significant impact on the price development of direct and parallel imports. It can be stated that parallel imports are likely to generate significant savings in Finland and the expansion of the reference price system has contributed to the ability of parallel imports to generate savings. However, further research on the real savings generated by parallel imports is still needed.
  • Lääkkeiden rinnakkaismaahantuonnin ja viitehintajärjestelmän vaikutukset suoratuonti- ja rinnakkaismaahantuontivalmisteiden hintojen sekä viitehintojen kehitykseen Suomessa 
    Helle, Emilia (2021)
    Background. Parallel importing of pharmaceuticals has potential to generate significant savings but results of previous theoretical and empirical studies on the consequences of parallel importing and its ability to generate competition have been contradictory. Little research on the effects of parallel importing has been conducted in Finland. In April 2017, the reference price system in Finland was extended to also cover substitution groups determined on the basis of parallel imports. The aim of the reform was to increase competition between direct and parallel imports and thus to generate savings in reimbursement costs. However, the impact of the reform has not yet been significantly studied. Aim. The aim of this study was to examine the effects of parallel importing and the expansion of the reference price system on the price development of direct and parallel imported medicines and reference prices. The purpose was to investigate in general the price development of products and reference prices in the period following the expansion of reference price system, to examine the importance of how long a reference group was involved in the system on price development, to examine the impact of the extension of the reference price system and the market entry of a competing parallel import in particular on prices of direct imported products and to examine the importance of the number of parallel imports competing with the direct imported product on price development. Methods. Reference price decisions and lists of prices of reimbursable medicinal products were used as research material. The data was found on the website of the Pharmaceuticals Pricing Board. Quarterly price data on the prices of products belonging to the reference price groups determined on the basis of parallel imports was extracted from the data. Price data was examined from January 2016 to October 2019. Price development was monitored as percentage changes on a quarterly and annual basis. The effect of extension of the reference price system and the entry of a competing parallel import was examined using a sort of before-after set-up by comparing the price development of products before the change to the price development of products after the change. Regression analysis was used to assess the statistical significance of the variables explaining price development of products. Results and conclusions. During the period, the prices of direct and parallel imports and the reference prices decreased in most of the reference price groups. Price increases amongst the groups were very rare. Based on price development and regression analyzes, both the expansion of the reference price system and the market entry of a competing parallel import significantly reduced the prices of direct imports. However, the time that the reference group was involved in the reference price system or the number of parallel imports competing with the direct import did not have a significant impact on the price development of direct and parallel imports. It can be stated that parallel imports are likely to generate significant savings in Finland and the expansion of the reference price system has contributed to the ability of parallel imports to generate savings. However, further research on the real savings generated by parallel imports is still needed.

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