Primary Care and Prescription Drugs: Coverage, Cost-Sharing, and Financial Protection in Six European Countries

Examines health coverage, innovations in cost-sharing design, and affordability of primary care and prescription drugs in Denmark, France, Germany, the Netherlands, Sweden, and the United Kingdom. Explores lessons for U.S. reforms and insurance design

Evidence of comparative efficacy should have a formal role in European drug approvals

Despite methodological concerns, comparative efficacy evidence should be required at the time of drug approval, says Corinna Sorenson and colleagues, to allow patients, clinicians, and other healthcare decision makers to determine whether a new drug is superior, equivalent, or inferior to its existing alternatives

Crowdfunding our health: economic risks and benefits

Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health

A critical analysis of the review on antimicrobial resistance report and the infectious disease financing facility

Over the past year, two major policy initiatives have been introduced focusing on stimulating antibiotic development for human consumption. The European Investment Bank has announced the development of the Infectious Disease Financing Facility (IDFF) and the British government commissioned the Review on Antimicrobial Resistance, led by Jim O’Neill. Each constitutes a major effort by the European community to address the evolving crisis of antimicrobial resistance. Though both have similar goals, the approaches are unique and worthy of consideration. This manuscript utilizes a previously published framework for evaluation of antibiotic incentive plans to clearly identify the strengths and weaknesses of each proposal. The merits of each proposal are evaluated in how they satisfy four key objectives: 1) Improve the overall net present value (NPV) for new antibiotic projects; 2) Enable greater participation of Small to Medium Sized Enterprises (SME); 3) Encourage participation by large pharmaceutical companies; 4) Facilitate cooperation and synergy across the antibiotic market. The IDFF seeks to make forgivable loans to corporations with promising compounds, while the O’Neill group proposes a more comprehensive framework of early stage funding, along with the creation of a stable global market. Ultimately, the proposals may prove complementary and if implemented together may form a more comprehensive plan to address an impending global crisis. Substantial progress will only be made on these efforts if action is taken at an international level, therefore we recommend consideration of these efforts at the upcoming G20 summit

Value in cancer drug spending: assessing the clinical risks and benefits from a decade’s worth of innovation

There are growing questions about the value from spending on what seem like ever-more expensive cancer medicines. Rising expenditures may make it difficult for patients to access or remain compliant with life-extending therapies. Yet, some have argued that high prices may be justified if new and innovative treatments offer significant clinical benefits. Even as studies point to gains in overall survival from innovative cancer medicines, efforts to examine the value from related expenditures remain stymied by a dearth of systematic evidence on their clinical risks and benefits. This lack of evidence makes it difficult to demand more from innovation, and, where costs factor into the decision-making process, for clinicians and patients to balance preferences for the expected impact from treatment against rising drug costs

Timely publication and sharing of trial data: opportunities and challenges for comparative effectiveness research in cardiovascular disease

There is growing enthusiasm for the timely publication and sharing of clinical trial data. The rationale for open access includes greater transparency, reproducibility, and efficiency of the research enterprise. In cardiovascular diseases, routinely sharing clinical trial data would create opportunities for undertaking comparative effectiveness research, providing much needed evidence on how different interventions compare to each other on key outcomes. Access to individual patient-level data would strengthen the validity of such research. Novel methodological approaches like network meta-analyses using individual patient-level data could reliably compare interventions that have not been compared to each other in head-to-head trials. However, there are significant practical, methodological, financial, and legal challenges to this utopian open access that need to be continually addressed. Sharing clinical trial data openly will only occur when the previously tolerated process of clinical research involving direct ownership and secrecy is abandoned for a new culture in which medical science is open to all of its stakeholders. With this new culture, data will be accessible, reanalysis and further analysis will be considered commonplace, and comparative effectiveness research through novel synthesis approaches such as network meta-analysis can thrive—as long as measures are taken to adequately ensure the goal remains to promote public health

Targeting innovation in antibiotics

Antimicrobial resistance (AMR) is currently responsible for over 700,000 deaths annually around the world. AMR mortality is predicted to rise exponentially to above 10 million deaths per year by 2050. The global economic cost of such a rise in mortality and morbidity is estimated to be $100 trillion

Before vaccines, government interventions were more effective at controlling COVID-19 when combined with economic support measures

Before the development of COVID-19 vaccines to reduce the spread of the virus, US state and federal authorities were limited to non-pharmaceutical interventions such as school and workplace closures, the cancelation of public events, and public information campaigns. In new research, Theologos Dergiades, Costas Milas, Elias Mossialos, and Theodore Panagiotidis look at the effects of these interventions in the early days of the pandemic. They find that, in the absence of a vaccine, when used alongside economic support measures, such interventions were effective in controlling the growth of COVID-19 infections