• Value Health · Jul 2017

    Pharmaceutical Pricing in Germany: How Is Value Determined within the Scope of AMNOG?

    • Victoria Desirée Lauenroth and Tom Stargardt.
    • Hamburg Center for Health Economics, Hamburg, Germany. Electronic address: Victoria.Lauenroth@wiso.uni-hamburg.de.
    • Value Health. 2017 Jul 1; 20 (7): 927-935.

    ObjectivesTo analyze how value is determined within the scope of the German Pharmaceutical Restructuring Act, which came into effect in 2011.MethodsUsing data from all pharmaceuticals that had undergone assessment, appraisal, and price negotiations in Germany before June 30, 2016, we applied generalized linear model regression to analyze the impact of added benefit on the difference between negotiated prices and the prices of comparators. Data were extracted from the Federal Joint Committee's appraisals and price databases. We specified added benefit in various ways. In all models, we controlled for additional criteria such as size of patient population, European price levels, and whether the comparators were generic.ResultsOur regression results confirmed the descriptive results, with price premiums reflecting the extent of added benefit as appraised by the Federal Joint Committee. On the substance level, an added benefit was associated with an increase in price premium of 227.2% (P < 0.001) compared with no added benefit. Moreover, we saw increases in price premium of 377.5% (P < 0.001), 90.0% (P < 0.001), and 336.8% (P < 0.001) for added benefits that were "considerable," "minor," and "not quantifiable," respectively. Beneficial effects on mortality were associated with the greatest price premium (624.3%; P < 0.001), followed by such effects on morbidity (174.7%; P < 0.001) and adverse events (93.1%; P = 0.019).ConclusionsPrice premiums, or "value," are driven by health gain, the share of patients benefiting from a pharmaceutical, European price levels, and whether comparators are generic. No statement can be made, however, about the appropriateness of the level of price premiums.Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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