International Health Care Systems

International Reference Pricing: Cross-country comparison

The price of pharmaceuticals are much higher in the U.S. than in other countries. Some policymakers have claimed that international reference pricing could be used to lower the cost of drugs in the U.S. For instance, the Lower Drug Costs Now Act (HR 3) proposed setting the maximum negotiated price Medicare would pay at 120% …

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Digital health in Europe: Before and after COVID

An interesting report from the European Observatory on Health Systems and Policies examined the “Use of digital health tools in Europe: before, during and after COVID-19“. Digital health is important not only because the technologies facilitate communication and disease monitoring, but also the technologies facilitate the creation of data that can be used to better …

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Biosimilar use in France

Like generic drugs for small molecules, biosimilars offer the hope for reducing drug prices after biologic therapies lose their patent protections. But how big an impact do biosimilars have and how comfortable are physicians with using these substitute products? A paper by Robinson and Jarrion (2021) use data from France as a case study to …

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Demand curves still slope downwards

Unsurprisingly, high-deductible health plans lead to lower utilization of healthcare services. A study by Sandoval et al. (2021) use data from 2007-2019 from Switzerland to show that this is the case. Participants with high-deductible plans reported forgoing health care more frequently than those with low-deductible plans (331 [13.5%] vs 591 [8.7%]). In adjusted analysis, higher-deductible …

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How easy is it for patients to access cell and gene therapies in Europe?

Cell and gene therapies have the potential to produce dramatic improvements in quality of life and survival for severe and often rare diseases. Currently, however, the cost of these treatments is high and access is sometimes limited. To identify some of these challenges in Europe EURODIS conducted an evaluation of country-specific challenges with respect to …

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International Reference Pricing: List vs. Net Pricing issues

Leah Rand and Aaron Kesselheim have an interesting commentary in Value in Health reviewing some of the challenges of implementing international reference pricing (IRP) in the U.S. IRP would set drug prices in the U.S. as no higher than a basket of drug prices in other developed countries. This issue is of particular interest due …

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A value framework for diagnostics in Latin America

That is the topic of a recent paper by Augustovski et al. (2021). The authors conduct a targeted literature review of previous diagnostics value frameworks in other countries. A full list of these articles is below. Then the researchers pool the criteria and created a proposed value framework. A panel of experts was then met …

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Paying for mental health care in the Netherlands

As COVID-19 has made many of us acutely aware, providing high quality mental health care is vital. However, the mental health care market is a difficult one for insurers; there is evidence that uncertainty and variation in treatments are greater compared to physical health conditions (for instance, see Frank et al. 2000). Thus uncertainty and …

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The 3Cs

The Economist has an interesting article on how Japan has been able to largely contain COVID-19. Part of the success has been a strong public health initiatives around avoiding the san-mitsu, or the “3Cs”. The 3Cs to avoid are: Closed spaces, Crowded places, and Close-contact settings. The phrase was blasted across traditional and social media. …

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Healthcare spending by age: An international comparison

We all know that health care spending per person in the US is highest among all countries. But are these results consistent across age groups? That is the question posed by Papanicolas et al. (2020). Using 2015 OECD data from the US and 7 other high-income countries (i.e., Australia, Canada, Germany, Japan, the Netherlands, Switzerland, …

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Health care battle: US vs. England

A new study by Choi et al. (2020) compares the health of individuals aged 55-64 in the US compared to England. They use data from Health and Retirement Study (HRS)–in the US–and the English Longitudinal Study of Ageing (ELSA) for 2008-2016. Health is measured across 16 outcomes: 5 self-assessed outcomes, 3 directly measured outcomes, and …

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Health care in Ukraine

Recently I read an interesting book called Moneyland by Oliver Bullough. The book describes how with porous borders facilitated by the internet, the rich can evade taxes, hide assets, and basically pick and choose the international legal system most favorable to their interests. One interesting part of the book discusses health care in the Ukraine …

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