title: Compared to US practice, evidence-based reviews in Europe appear to lead to lower prices for some drugs.
abstract: In Europe drug reimbursement decisions often weigh how new drugs perform relative to those already on the market and how cost-effective they are relative to certain metrics. In the United States such comparative-effectiveness and cost-effectiveness evidence is rarely considered. Which approach allows patients greater access to drugs? In 2000-11 forty-one oncology drugs were approved for use in the United States and thirty-one were approved in Europe. We compared patients' access to the twenty-nine cancer drugs introduced into the health care systems of the United States and four European countries. Relative to the approach used in the US Medicare program in particular, the European evidence-based approach appears to have led to reduced prices for those drugs deemed worthy of approval and reimbursement. The result is improved affordability for payers and increased access for patients to those drugs that were available. The United States lacks a systematic approach to assessing such evidence in the coverage decision-making process, which may prove inadequate for controlling costs, improving outcomes, and reducing inequities in access to care.
authors.affiliation: Center for the Study of Drug Development, Tufts University, Boston, MA, USA. Joshua.cohen@tufts.edu
authors.forename: Joshua
authors.initials: J
authors.lastname: Cohen
authors.forename: Ashley
authors.initials: A
authors.lastname: Malins
authors.forename: Zainab
authors.initials: Z
authors.lastname: Shahpurwala
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics / Q000627:therapeutic use; D057186:Comparative Effectiveness Research; D003363:Cost Control / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D017277:Drug Approval / Q000191:economics / Q000379:methods; D016527:Drug Costs / Q000706:statistics & numerical data*; D005060:Europe; D019317:Evidence-Based Medicine / Q000191:economics*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D054524:Medicare Part D / Q000191:economics; D055553:Prescription Drugs / Q000191:economics* / Q000627:therapeutic use; D014481:United States
chemical_list: D000970:Antineoplastic Agents; D055553:Prescription Drugs