Universidad Peruana Cayetano Heredia

Implications of global pricing policies on access to innovative drugs: the case of Trastuzumab in seven latin american countries

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dc.contributor.author Pichon-Riviere, Andres
dc.contributor.author Garay, Osvaldo Ulises
dc.contributor.author Augustovski, Federico
dc.contributor.author Vallejos, Carlos
dc.contributor.author Huayanay Falconí, Leandro
dc.contributor.author Bueno, Maria del Pilar Navia
dc.contributor.author Rodriguez, Alarico
dc.contributor.author de Andrade, Carlos Jose Coelho
dc.contributor.author Buendia, Jefferson Antonio
dc.contributor.author Drummond, Michael
dc.date.accessioned 2019-02-06T14:52:38Z
dc.date.available 2019-02-06T14:52:38Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5335
dc.description.abstract OBJECTIVES: Differential pricing, based on countries' purchasing power, is recommended by the World Health Organization to secure affordable medicines. However, in developing countries innovative drugs often have similar or even higher prices than in high-income countries. We evaluated the potential implications of trastuzumab global pricing policies in terms of cost-effectiveness (CE), coverage, and accessibility for patients with breast cancer in Latin America (LA). METHODS: A Markov model was designed to estimate life-years (LYs), quality-adjusted life-years (QALYs), and costs from a healthcare perspective. To better fit local cancer prognosis, a base case scenario using transition probabilities from clinical trials was complemented with two alternative scenarios with transition probabilities adjusted to reflect breast cancer epidemiology in each country. RESULTS: Incremental discounted benefits ranged from 0.87 to 1.00 LY and 0.51 to 0.60 QALY and incremental CE ratios from USD 42,104 to USD 110,283 per QALY (2012 U.S. dollars), equivalent to 3.6 gross domestic product per capita (GDPPC) per QALY in Uruguay and to 35.5 GDPPC in Bolivia. Probabilistic sensitivity analysis showed 0 percent probability that trastuzumab is CE if the willingness-to-pay threshold is one GDPPC per QALY, and remained so at three GDPPC threshold except for Chile and Uruguay (4.3 percent and 26.6 percent, respectively). Trastuzumab price would need to decrease between 69.6 percent to 94.9 percent to became CE in LA. CONCLUSIONS: Although CE in other settings, trastuzumab was not CE in LA. The use of health technology assessment to prioritize resource allocation and support price negotiations is critical to making innovative drugs available and affordable in developing countries. en_US
dc.language.iso eng
dc.publisher Cambridge University Press
dc.relation.ispartofseries International Journal of Technology Assessment in Health Care
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Latin America en_US
dc.subject Quality of Life en_US
dc.subject Developing Countries en_US
dc.subject Cost-Benefit Analysis en_US
dc.subject Costs and Cost Analysis en_US
dc.subject Antineoplastic Agents/adverse effects/economics/therapeutic use en_US
dc.subject Breast Neoplasms/drug therapy en_US
dc.subject Cost utility en_US
dc.subject Cost-effectiveness en_US
dc.subject drug pricing en_US
dc.subject Markov Chains en_US
dc.subject Models, Econometric en_US
dc.subject Quality-Adjusted Life Years en_US
dc.subject trastuzumab en_US
dc.subject Trastuzumab/adverse effects/economics/therapeutic use en_US
dc.title Implications of global pricing policies on access to innovative drugs: the case of Trastuzumab in seven latin american countries en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1017/S0266462315000094
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.02
dc.relation.issn 1471-6348


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