ABSTRACT
Several government payer systems, starting in the Netherlands and Germany in the early 1990s, have introduced highly formal Reference-Based Pricing (RBP) system of evaluating new drugs versus existing options. The most common methods of referencing are based on the World Health Organization Anatomical Therapeutic Classification system (ATC). The ATC system classifies drug groups based on their therapeutic activity and chemical structure. Potential for parallel trade and international price referencing continues to complicate the global pricing arena for drugs. Reference-based pricing systems have been contested by many, but despite that it is the basis for many drug reimbursement systems. Experience in New Zealand illustrates the potentially devastating effect of RBP systems. Reference-based pricing is one of most frequently applied methods of pricing and reimbursement control. A case study for Lipitor in Germany and some serious safety events in New Zealand highlights complexity of applying this approach safely and fairly.
