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IQWiG: First health economic evaluation completed
Date:10/30/2013

t for patients and the price reimbursed by the SHI funds shows marked differences between drugs; this applies to both outcomes. For each of the 4 drugs assessed, the current reimbursement price is higher than the "appropriate" price inferred from the respective efficiency frontier. However, 2 of the drugs assessed (mirtazapine and venlafaxine) have since been classified into a reference price group, meaning that the current price of each drug will probably have shifted closer to the efficiency frontier.

Legal situation has changed

The results of this health economic evaluation are not directly relevant to decision making, neither for drug prices nor for general reimbursement. This is due to a change in the legal situation since the report was commissioned. Originally, the results were supposed to form the basis of the decision on the setting of a "maximum reimbursable price" for drugs. This was the responsibility of the SHI umbrella organization ("GKV-Spitzenverband").

Since the introduction of the Act on the Reform of the Market for Medicinal Products (AMNOG), a health economic evaluation is primarily planned for the case where price negotiations fail after the regular early benefit assessment and where the arbitral verdict is also challenged. In this case the drug manufacturers or the SHI umbrella organization can apply for a health economic evaluation.

Successful test run

Despite the change in the legal situation, it was important for the Institute to complete the report. As the Institute's Director Jrgen Windeler explains: "We wanted to test whether the efficiency frontier method, which is the method preferred by IQWIG, is suitable and leads to robust results. And this test was successful. The report shows drug manufacturers and SHI funds what they can expect from a health economic evaluation and what not."

Challenges remain

IQWiG was also able to gain important experiences
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Contact: Dr. Anna-Sabine Ernst
presse@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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