24. marts - 10.15 martin knudsen

8/7/2019 24. Marts - 10.15 Martin Knudsen

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Medicin der virker

Martin S. KnudsenSenior Consultant

IMS Health Economics and Outcomes Research


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Emner

Hvordan er lgemiddel markedet i Danmark set i forhold tilEuropa og det globale marked

Er udgifterne hje, hvorfor stiger de

Hvad betyder lgemidler for national konomien Afspejler priserne behandlingseffekten, er der muligheder I

value based pricing


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2011 sales and growth

Japan

Size: U.S.$95-100bn

Growth: 5-7 %

US

Size: U.S.$320-330bn

Growth: 3-5 %

Top 5 Europe


Growth: 1-3 %

Pharmerging Markets


Growth: 15-17 %

Rest of World


Growth: 3-5 %

Global Market

Size: $880-890bn

Growth: 5-7 %

2011 Sales and growthSource: IMS Health, Market Prognosis, Sep 2010

China Venezuela Egypt

Brazi l Poland Thai land

Russia Argentina Romania

India Indonesia Pakistan

Mexico S. Africa Vietnam

Turkey Ukraine


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Global Pharma growth to remain in single digitsA trillion dollar market by 2014 energised by emerging markets

0

200

400

600

800

1000

1200

2010 (

) 2011 (

) 2012 (

) 201 (

) 2014(

)

ALUE

ALESUS$

N

0%

5%

10%

15%

20%

25%

0%

ALUEG

W

%(

onst

US$)

Global USAEU5 Ja an

ier 1 Pharmerging

ier 2 Pharmerging

ier Pharmerging

Source: IMS Health Market Prognosis September 2010; Tier 1 = China; Tier 2 = Brazil, Russia, India; Tier 3 = Venezuela, Poland, Argentina,Turkey, Mexico, Vietnam, S. Africa, Thailand, Indonesia, Romania, Egypt, Pakistan, Ukraine

Global Sales and Market Growth Pharmaco challenges

Global Pharma Market Dynamics & Current Economic Environment

US/EU / apan no longer dominateglobal growth

ower GDP growth and tax revenues

will impact healthcarebudgets/promote more aggressivecost containment

New product launches are notreplacing revenues lost to genericcompetition, especially in primarycare

Emerging markets present the mostattractive areas for growth

Increased pricing & reimbursementpressures


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2001 Rank 2006 Rank 2011 Rank

1 United States 1 United States 1 United States2 apan 2 apan 2 apan3 France 3 France 3 China4 Germany 4 Germany 4 Germany

Italy Italy France United Kingdom Canada Italy7 Canada 7 Spain 7 Brazil

Spain United Kingdom Canada9 China 9 China 9 Spain10 Brazil 10 Brazil 10 United Kingdom11 Mexico 11 Mexico 11 Russia12 Australia 12 Australia 12 India13 South Korea 13 South Korea 13 South Korea14 India 14 Russia 14 Australia

1

Netherlands 1

India 1

Mexico1 Russia 1 Turkey 1 Turkey17 Poland 17 Netherlands 17 Venezuela1 Belgium 1 Poland 1 Poland19 Portugal 19 Belgium 19 Greece20 Switzerland 20 Greece 20 Belgium

Leading pharmerging markets projected to climb inthe 2011 global market ranking

Source: IMS Health Market Prognosis, Sep 2010. Market size ranking in constant US

Chinaexpected toenter 2011

as #3 market


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Den samlede udgift til lgemidler i DK stiger, isr isygehussektoren

Samlet omstning af lgemidler i DK, rets priser

0

2.000

4.000

6.000

8.000

10.000

12.000

14.000

16.000

2005 2006 2007 2008 2009

Mio.kr

Sygehus sektor Primr sektor


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men gennemsnits prisen falderLgemiddelpriser DK 2005-2010, indeks 2005-12=100

50

60

70

80

90

100

110

2005

-12

2006

-03

2006

-06

2006

-09

2006

-12

2007

-03

2007

-06

2007

-09

2007

-12

2008

-03

2008

-06

2008

-09

2008

-12

2009

-03

2009

-06

2009

-09

2009

-12

2010

-03

2010

-06

2010

-09

2010

-12

Indeks,2

005-12=100

DDD-baseret indeks Receptpligt. lgemidler m. tilskudsstatus AIP

DDD-baseret indeks Alle lgemidler undt. lib. sortiment AIP

Alle lgemidler

Recept

Kilde; Lgemiddelstyrelsen


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Netto eksport af lgemidler Schweiz er strst,Danmark er nummer i Europa

" # # $ " # # % " # # & ' ( ( ( ' ( ( ' ' ( ( $ ' ( ( % ' ( ( &

- $

&

$

' (

" %

" '

(

IRELAND

S) ITZER-LAND

UNITEDKINGDOM

S)

EDEN

GERMANY

FRANCE

DENMARK

BELGIUM

AUSTRIA

Trade balance (2010)(Billion

Source: EuroStat. *Trade balance calculations are made by subtracting revenues spent on importing from revenues made from exporting.EFPIA, The Pharmaceutical industry in figures, 2010 edition

Trade balance*(Billion , MAT

Trade of Medical and Pharmaceutical Products

100

SLOVENIA

DENMARK

S 0 EDEN

BELGIUM

FRANCE

UK

IRELAND

GERMANY

S 0 ITZERLAND

1 1 1 20


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99

Outside the UK/US which are first and fast there is a range ofuptake times across market but on average Denmarks marketis opened quickly

2

3 2 2

4 2 2

5 2 2

6 2 2

7 2 2 2

7 3 2 2

7 4 2 2

elgium

Slov

akia

Austria ta

lyrance

unga

rySp

ain

echrepu

blic

Slov

eniareece

ston

iaolan

d

ortugal

Swit

erland

ethe

rlands

Swed

en

inland

orway

reland

Den

mark

ermany UK US

Delay

8

day

s9

@ aA imum/ @ inimum Average

Range of timedelays betweenmarketing

authorisation andmarket accesshospital and

retail combined

All new medicineswith marketingauthorisation from

anuary 3 to3 December


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Protected NLP GenericsTotal

Share% / Dose Share% / Dose Share% / Dose

POL 0% 0.91 9% 0.26 91% 0.16 0.17

DNK 14% 1.10 2% 0.31 84% 0.03 0.18

FIN 9% 0.92 21% 0.23 70% 0.08 0.18

SWE 15% 1.14 2% 0.23 83% 0.03 0.20

DEU 7% 1.12 27% 0.17 66% 0.13 0.21

NOR 3% 1.10 24% 0.48 74% 0.10 0.22

CZE 3% 0.91 28% 0.25 69% 0.20 0.24

GBR 29% 0.80 1% 0.45 69% 0.05 0.28

AUT 18% 0.93 13% 0.36 69% 0.24 0.38

HUN 11% 0.58 15% 0.38 74% 0.36 0.39

NLD 39% 0.93 4% 0.24 57% 0.04 0.40

PRT 24% 0.68 9% 0.44 67% 0.33 0.43

FRA 44% 0.69 19% 0.25 37% 0.26 0.44

ESP 5% 1.09 43% 0.78 52% 0.18 0.48

ITA 51% 0.75 26% 0.29 23% 0.21 0.51

BEL 38% 1.06 22% 0.26 40% 0.16 0.52

CHE 46% 1.12 10% 0.64 44% 0.44 0.78

GRC 44% 1.00 8% 0.77 47% 0.84 0.91

IRL 76% 1.13 14% 0.77 11% 0.70 1.04

Source: IMS Health Monthly MIDAS, Q3/10. Market share in volume (SUB and price in Euros at MNF level.

Original Brands Statiner


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Health Technology Assessment (HTA) anvendt plgemidler

"Health Technology Assessment" svarer nogenlunde til detdanske koncept for Medicinsk Teknologi Vurdering (MTV)

Anvendes som betegnelse for en systematisk evaluering aflgemidler som bde omfatter kliniske data og konomi

Er i varierende grad et krav til godkendelse af markedsadgang og/eller tilskudsstatus i en del lande


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Influences price & access

Influences access only

Limited influence on price/ access

FR

IT

AU

DN HUIR

CH

SWPL PO

UK DE

Part ofP&R

process

HTA isseparateprocess

Part ofP&R

process

Organizationally, HTAs have beenset up with a wide range of levelsof influence and incorporationinto the P&MA process

HTA bodies can be part of the

P&R process or separate These HTA bodies can

influence two factors

- Price and Access

- Access only

The range of influence varies

widely by countries- In countries, HTA bodies

exist but have limitedinfluence

CZ GR

EST

LI

LV

BEL

SK

TUSL RO

NO

BUL

NE

FI

SP

Most EU27 countries report that a formal HTAprocess exists in their market at the national level

Source: IMS Consulting research among a number of P&R authority officials and industry affiliates in 200 C


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Value based pricing en international tendens?

Udfordring

Priser for patentbeskyttede produkter afspejler ikke behandlingens vrdi

forskel paa priser for produkter med ensartet effekt Usikkerhed om langsigtede konsekvenser begrnser adgang til nye produkter Behov for fleksible priser naar produkter anvendes til forskellige indikationer Priskontrol/reduktion hmmer investerings lysten (UK)

Lsning (?)= Value based pricing

Maximal pris betinget af behandlings effekt

Risk sharing hvis behandlingen ikke virker betales der tilbage

Status

Anvendes bl.a i Sverige og flere europiske lande

I UK planlgger man at erstatte det nuvende PPRS system med et system baseretpaa value based pricing i 2013


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Value based pricing - eksempler

Sverige

Duodopa blev tilskudsberettiget i 2003 med tidsbegrnsningunder forudstning af at yderligere dokumentation kunne pviseen omkostnings effektivitet p et rimeligt niveau. Frst I 200 fikDuodopa en endelig accept.

UK

Det overvejes at graduere standarden for, hvad der er omkost-ningseffektivt, s man belnner ny medicin paa srlige omrder

stort behandlingsbehov (unmet need)

Innovativ medicin, signifikant bedre effect

Bredere samfundsmssige gevinster


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Sammenfatning

Danske medicinudgifter er i international sammenhng ikkemarkant hje.

Danmark har forholdvis hj beskftigelse i en medicinalindustri, som bidrager positivt til betalingsbalancen.

Ny medicin lanceres relativt hurtigt og Danmark har et hjtoptag af ny medicin.

Bortfaldet af patenter har medvirket til faldende priser.

Udgifterne er de seneste r drevet op af ny sygehusmedicin.

Value based pricing kan mske levere en ramme forintroduktion af ny medicin.


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Tak for opmrksomheden!

24. marts - 10.15 martin knudsen

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