Driven by changing demographics and increasing medical costs, both mature and emerging markets are adopting novel strategies to manage their domestic healthcare systems. A range of methods are being adopted across the globe in an effort to optimize healthcare and manage the increasing costs associated with aging populations (in the mature markets) and with growing expectations (in emerging markets). Examples include market-entry agreements, risk-sharing, and value-based pricing in many European markets, government-driven efforts to encourage knowledge transfer that will allow the creation of a biologics manufacturing industry in Latin America, and relaxing requirements for local clinical trials in Asia without risking patient safety. Separately, decisions that occur outside of government can still influence the national experience with healthcare such as in the United States, where consolidation of PBMs and their willingness to exert their power have led to increasing power to negotiate on price in a market largely untouched by the type of cost pressures experienced in other developed markets. For any healthcare system seeking to improve, examples such as these (and others) provide opportunities to leverage prior experience and avoid prior mistakes.

Questions Answered in This Report:

  • What are some examples of good practice in healthcare systems around the world that could be replicated to good effect? How and where have these been implemented? What effect have these had on stakeholders operating within these systems?

  • What has been the effect of payers in the United States increasingly negotiating more aggressively on price? What are some examples of disease markets where these negotiations have had the biggest impact? How have physicians treating these conditions been affected? How have patients been impacted?

  • How do market entry and risk-sharing agreements impact stakeholders in regions where these agreements are utilized? What were the earliest examples of these types of agreements? Which countries are leading the way in implementing these arrangements within their healthcare systems? How do these agreements impact physicians and patients?

  • What are the impacts of certain specific local requirements around the world for the countries employing these? Are requirements for local clinical trials such as Japan a positive or negative for local stakeholders and what is the scope for relaxing these requirements? How is Brazil encouraging inward knowledge transfer by pharmaceutical companies through its PDP program?
Author(s): Matthew Scutcher, M.Eng., Ph.D.