scholarly journals Cost-savings and potential cost-savings through the distribution of generic antiretroviral drugs within the statutory health insurance market of Germany between January 2017 and June 2019

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Matthäus Lottes ◽  
Viviane Bremer ◽  
Christof Prugger ◽  
Christian Kollan ◽  
Daniel Schmidt
Keyword(s):  
Health Insurance ◽  
Cost Saving ◽  
Treatment Guidelines ◽  
Statutory Health Insurance ◽  
Generic Drugs ◽  
Cost Savings ◽  
Antiretroviral Drugs ◽  
Potential Cost ◽  
Defined Daily Doses ◽  
Tenofovir Alafenamide

Abstract Background Recent patent losses for antiretroviral drugs (ARV) have led to the debate of cost-saving through the replacement of patented drugs with generic drugs. The split of recommended single-tablet regimens (STR) into their single substance partners is one of the considerations mentioned in said debate. Particularly, generic tenofovir disoproxil/emtricitabine (TDF/FTC) is expected to hold untapped cost-saving potential, which may curb increasing overall expenditures for combined antiretroviral therapy (cART) within the statutory health insurance (SHI) of Germany. Methods Data of ARV reimbursed by the SHI were used to describe the trends of defined daily doses (DDD) as well as the revenue within the German ARV market. They were also used to determine the cost-savings of moving to generic drugs. The time period observed was between January 2017 and June 2019. The potential cost-savings were determined with following assumption in mind: the maximum possible use of generic ARV, including 1) the split of STR and replacing all substance partners with generic ones, and 2) replacing patented tenofovir alafenamide/emtricitabine (TAF/FTC) with generic TDF/FTC. Results Throughout the observation period, the DDD of generic ARV increased nearly five-fold while their revenue increased more than four-fold. Total cost-saving showed a sharp increase over the same period, with generic TDF/FTC accounting for a share of around 70%. The largest potential cost-saving could have been achieved through replacing patented TAF/FTC with generic TDF/FTC, peaking at nearly 10% of total revenue, but showing decreasing trends in general. Conclusion The progressive distribution of generic ARV ensured increasing cost-savings, but consequently curbed the potential cost-savings. Unique price reductions of generic TDF/FTC have played a pivotal role for these effects. In any case, substituting with generic ARV should not fail to adhere to the treatment guidelines and continue to consider the medical requirements for the treatment.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

scholarly journals Maximum potential cost-savings attributable to generic substitution of antipsychotics 2008 to 2013

2016 ◽  
Vol 21 ◽  
pp. 356-363
Author(s):  
D. Husselmann ◽  
R. Joubert ◽  
J. R. Burger ◽  
M. S. Lubbe ◽  
M. Cockeran
Keyword(s):  
Cost Saving ◽  
Generic Substitution ◽  
Cost Savings ◽  
Economic Benefits ◽  
Community Treatment ◽  
Prescribing Patterns ◽  
Potential Cost Saving ◽  
Potential Cost ◽  
Total Potential ◽  
Nationally Representative

Background: Schizophrenia is a costly illness to treat, especially during a time of escalating medicine inflation costs, putting a large economic strain on patients, their families and the community. Treatment, however, can become more affordable through generic substitution.Objective: To determine the maximum potential cost-saving through generic substitution for both originator and more expensive generic items while observing the prescribing patterns of antipsychotics.Method: Antipsychotic medicine usage was analysed retrospectively during the study period 2008 to 2013 using data obtained from a nationally representative Pharmaceutical Benefit Management Company. The study population consisted of 4410 patients with ICD-10 codes (F20-F20.9) who had paid claims for an antipsychotic reimbursed from their prescribed minimum benefits. Active ingredients were identified using the MIMS classification system. Maximum potential cost savings were determined by substituting all originator and more expensive generic antipsychotic items with the cost of the least expensive generic antipsychotic item available.Results: Through generic substitution, a total potential cost-saving of ZAR4 642 685.45 could be possible from 2008 to 2013. Average cost per items increased from ZAR600.53 ± ZAR435.00 (median ZAR 539.82) in 2008 to ZAR1 196.59 ± ZAR 942.16 (median ZAR 940.72) in 2013 and had a significant effect on patients' contribution, which increased with 726.94% from 2005 to 2008. Psychiatrists prescribed the majority of antipsychotics. Although generic items claimed increased by 60.31% during the study period, psychiatrist still favoured non-generic prescribing (40.63%).Conclusions: Potential economic benefits can be generated with generic substitution.

Cost Saving of Stress Ulcer Prophylaxis Used in Non-Intensive Care Unit (ICU) Inpatients

2020 ◽  
Vol 3 (1) ◽  
pp. 37-43
Author(s):  
Hening Pratiwi ◽  
Laksmi Maharani ◽  
Ika Mustikaningtias
Keyword(s):  
Cost Saving ◽  
Stress Ulcer ◽  
Cost Savings ◽  
Stress Ulcer Prophylaxis ◽  
Rank Test ◽  
Potential Cost ◽  
Significant Difference ◽  
Before And After ◽  
Ulcer Prophylaxis ◽  
American Society

Stress ulcer prophylaxis (SUP) is largely prescribed to ICU and non-ICU patients. SUP, an acid-suppressive drug, is overused in hospital settings mainly due to inadequate prescriptions in low-risk patients. In this context, the appropriate administration of SUP needs to be analyzed, and the potentially saved money from reducing excessive use can thereby be quantified. This study was intended to calculate potential cost savings in inappropriate SUP therapy in non-ICU inpatients. With a non-experimental retrospective design, it analyzed medical records and details obtained from the financial department of “X” hospital in Purwokerto, Indonesia. The data were collected from 80 non-ICU inpatients in May 2015, which were selected by purposive sampling. We calculated potential cost savings by referring to the American Society of Health-System Pharmacists (ASHP) guidelines that had been modified by Zeitoun (2011) for stress ulcer prophylaxis in non-ICU inpatients. The results showed that inappropriate indications and doses were found in 32.5% and 18% of selected patients, respectively. Before the cost-saving calculation, patients had to spend USD 2,411. However, after the analysis eliminated unnecessary SUP use, this number was proven to be potentially decreased by USD 512 to only USD 1,899. Based on the Wilcoxon Sign Rank Test result (p = 0.000 (≤ 0.05)), there was a significant difference between the total cost before and after the application of modified ASHP guidelines for appropriateness. After a thorough assessment, we concluded that the treatment cost could be reduced by identifying and excluding inappropriateness in SUP therapy.

scholarly journals Cost-savings accruable to removing value added tax from antiretrovirals in the South African private health sector

2017 ◽  
Vol 22 ◽  
Author(s):  
Varsha Bangalee ◽  
Fatima Suleman
Keyword(s):  
Cost Saving ◽  
Policy Development ◽  
Value Added ◽  
Antiretroviral Drugs ◽  
Essential Medicines ◽  
Healthcare Sector ◽  
Fixed Dose ◽  
Potential Cost Saving ◽  
Value Added Tax ◽  
Potential Cost

Background: Despite the important and essential role that medicines play in any society, all medicines, including those identified as essential, are uniformly subjected to 14% value added tax (VAT), regardless of their therapeutic value in the private healthcare sector of South Africa. The aim of this article is to demonstrate the potential cost-saving attained from the removal of VAT from the private sector pricing of essential medicines, using antiretroviral treatment as an example.Methods: An empirical analysis was undertaken to illustrate the potential cost-saving achieved by removing VAT from the Single Exit Price and the dispensing fee of essential medicines. This outcome was demonstrated by applying the methodology to an adult fixed dose combination 1st line antiretroviral regimen as well as to a group of 3rd line antiretroviral medicines.Results: The potential saving for the lowest priced generic and originator 1st line antiviral regimen accrued to ZAR 693.84 and ZAR 1085.04 over a year respectively. Regarding the 3rd line antiretroviral drugs, results yielded an annual saving of ZAR 1678.68 (darunavir), ZAR5741.04 (maraviroc) and ZAR 159.48 (rilpivirine).Conclusions: Lobbying for the removal of VAT from the supply chain of medicines should be intensified. Policy development to monitor and recover lost government revenue through the removal of taxes should be explored.

scholarly journals Stability of Extemporaneously Prepared 0.5-Percent Caspofungin Eye Drops: a Potential Cost-Savings Exercise

2012 ◽  
Vol 56 (6) ◽  
pp. 3435-3437 ◽  
Author(s):  
Chin Fen Neoh ◽  
Jovan Jacob ◽  
Lok Leung ◽  
Jian Li ◽  
Angela Stathopoulos ◽  
...  
Keyword(s):  
High Performance Liquid Chromatography ◽  
Liquid Chromatography ◽  
Cost Saving ◽  
High Performance ◽  
Hplc Analysis ◽  
Cost Savings ◽  
Fungal Keratitis ◽  
Eye Drops ◽  
Potential Cost ◽  
The Cost

ABSTRACTWhile the successful use of topical caspofungin for patients has been reported, topical caspofungin is not commercially available and its stability is unknown, limiting its usefulness in treating fungal keratitis. Caspofungin (0.5%) eye drops were aseptically prepared, and the concentrations were measured using a validated high-performance liquid chromatography (HPLC) analysis. The preparations remained stable for 28 days under refrigerated condition but not at 25.0°C. Our study supports the cost-saving use of caspofungin eye drops in the clinical setting.

scholarly journals Impact of dose rounding of cancer therapy on cost avoidance: a pilot study

2013 ◽  
Vol 14 (4) ◽  
pp. 169-172 ◽  
Author(s):  
Nagwa Ibrahim
Keyword(s):  
Targeted Therapy ◽  
Cancer Therapy ◽  
Cost Saving ◽  
Medical Oncology ◽  
Cost Savings ◽  
Potential Cost ◽  
Biologic Drugs ◽  
The Past ◽  
Chemotherapy Agents ◽  
Theoretical Cost

BACKGROUND: A significant and progressive cost rising in medical oncology due to the incorporation of novel and highly expensive drugs into clinical practice have been seen in the past ten years. Dose rounding is an option might be used in oncology settings to avoid extra cost. The purpose of this project is to determine the theoretical cost saving related to a dose rounding process for biological and chemotherapy agents in adult oncology settings and to determine the opinion of oncologists about dose rounding.MATERIALS AND METHODS: Data was obtained prospectively during April 2011. All chemotherapy and targeted therapy orders prescribed in adult oncology outpatient clinics as well as in-patient wards have been collected. We considered rounding to an amount within 15% for targeted therapy and 10% for cytotoxic drugs. Chemotherapy dosing was calculated according to body surface area. Prescriptions that include cancer therapy in doses that might be rounded according to study criteria were identified.RESULTS: Two hundred and thirty three orders of chemotherapy and targeted therapy were processed by Adult Oncology Satellite Pharmacy during the period of data collection. Forty percent of the collected prescriptions fulfilled the criteria. The potential cost savings from dose rounding per year was $192,800. Data was extrapolated from the determined monthly cost savings. The highest cost saving was for breast cancer orders $80,820 (42%), followed by colorectal cancer $47,965 (25%), while in non-Hodgkin's lymphoma cost savings was $ 45,107 (23%) and for other types of cancer that include non small cell lung cancer, prostate and ovarian cancer, in addition to head and neck cost savings was $18,867 (10%).CONCLUSIONS: Our experience confirms the significant cost savings of cancer therapy by applying dose rounding to chemotherapy and biologic drugs prescriptions. While clinical impact of the suggested percentage needs to be evaluated.

Hämophiliebehandlung als ganzheitliches Konzept der Patientenversorgung

2012 ◽  
Vol 32 (S 01) ◽  
pp. 25-S28
Author(s):  
H. Rott ◽  
G. Kappert ◽  
S. Halimeh
Keyword(s):  
Health Insurance ◽  
Effective Treatment ◽  
International Research ◽  
Statutory Health Insurance ◽  
Interdisciplinary Team ◽  
Legal Basis ◽  
University Hospitals ◽  
Innovative Treatment ◽  
Social Law ◽  
Treatment Concepts

SummaryA top quality, effective treatment of haemophilia requires an integrated therapeutical concept and an excellent cooperation of an interdisciplinary team. Since years different models are discussed in Germany in order to enlarge the offers for a suitable care of patients with hard to treat diseases. The healthpolitical targets are expressed in the changes of the Code of Social Law number V (SGB V) and in innovations in the statutory health insurance. This new legal basis provides opportunities to implement innovative treatment concepts outside university hospitals and paves the way for ambulant haemophilia centres to offer an integral care, all legally saved by a contract.The Coagulation Centre Rhine-Ruhr reveals as an example how haemophilia treatment in accordance with guidelines and with the latest results of international research can be realise in an ambulatory network.

Integrated Tubulars Supply Model Provides Cost Savings to Drilling Projects

2020 ◽  
Author(s):  
M. Hamzah
Keyword(s):  
Supply Chain ◽  
Cost Savings ◽  
Asia Pacific ◽  
Potential Cost ◽  
Alternative Scheme ◽  
Safety Stocks ◽  
Storage Location ◽  
Supply Planning ◽  
Drilling Site ◽  
Drilling Project

Classical Oil Country Tubular Goods (OCTG) procurement approach has been practiced in the indus-try with the typical process of setting a quantity level of tubulars ahead of the drilling project, includ-ing contingencies, and delivery to a storage location close to the drilling site. The total cost of owner-ship for a drilling campaign can be reduced in the range of 10-30% related to tubulars across the en-tire supply chain. In recent decades, the strategy of OCTG supply has seen an improvement resulting in significant cost savings by employing the integrated tubular supply chain management. Such method integrates the demand and supply planning of OCTG of several wells in a drilling project and synergize the infor-mation between the pipes manufacturer and drilling operators to optimize the deliveries, minimizing inventory levels and safety stocks. While the capital cost of carrying the inventory of OCTG can be reduced by avoiding the procurement of substantial volume upfront for the entire project, several hidden costs by carrying this inventory can also be minimized. These include storage costs, maintenance costs, and costs associated to stock obsolescence. Digital technologies also simplify the tasks related to the traceability of the tubulars since the release of the pipes from the manufacturing facility to the rig floor. Health, Safety, and Environmental (HSE) risks associated to pipe movements on the rig can be minimized. Pipe-by-pipe traceability provides pipes’ history and their properties on demand. Digitalization of the process has proven to simplify back end administrative tasks. The paper reviews the OCTG supply methods and lays out tangible improvement factors by employ-ing an alternative scheme as discussed in the paper. It also provides an insight on potential cost savings based on the observed and calculated experiences from several operations in the Asia Pacific region.

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