ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2010
The impact of reference pricing on switching behaviour and healthcare utilisation: the case of statins in Germany.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Pharmaceutical policies: effects of reference pricing, other pricing, and purchasing policies.The Cochrane database of systematic reviews · 2014Pooled it
- Explaining why increases in generic use outpace decreases in brand name medicine use in multisource markets and the role of regulation.PloS one · 2024Article
- Pharmaceutical pricing dynamics in an internal reference pricing system: evidence from changing drugs' reimbursements.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Patterns of statin utilisation for new users and market dynamics in South Korea: a 13-year retrospective cohort study.BMJ open · 2019Article
- Introduction of therapeutic reference pricing in Slovenia and its economic consequences.The European journal of health economics : HEPAC : health economics in prevention and care · 2018Article
- The diffusion of generics after patent expiry in Germany.The European journal of health economics : HEPAC : health economics in prevention and care · 2016Article
- Impact of treatment with rosuvastatin and atorvastatin on cardiovascular outcomes: evidence from the Archimedes-simulated clinical trials.ClinicoEconomics and outcomes research : CEOR · 2015Review
- The impact of generic reference pricing in Italy, a decade on.The European journal of health economics : HEPAC : health economics in prevention and care · 2013Article
- Could co-payments on drugs help to make EU health care systems less open to political influence?The European journal of health economics : HEPAC : health economics in prevention and care · 2013Article
- Pitfalls associated with the therapeutic reference pricing practice of asthma medication.BMC pulmonary medicine · 2012Article
- Effects of reference pricing in pharmaceutical markets: a review.PharmacoEconomics · 2011Review
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This paper analyses (1) the impact of the inclusion of statins in the German reference pricing scheme in 2005 on the statin market, and (2) the effect of switching behaviour subsequent to the policy change on healthcare utilisation and costs. Patients with prescriptions for statins in 2004 were observed for 1 year before and 1 year after the policy change, which went into effect on 1 January 2005. Data on outpatient and inpatient visits, pharmaceutical consumption, and cost to the sickness fund were collected from a sickness fund with more than 5.8 million insured members in 2005. Compared to patients who were not affected by the policy change, patients treated previously with atorvastatin experienced higher non-adherence and increased discontinuation of treatment (P < 0.0001). Compared to patients who continued treatment with atorvastatin (non-switchers), patients who switched to another statin were hospitalised more often (P = 0.0439). However, difference-in-differences in hospitalisation due to coronary heart disease (P = 0.8751) and emergency visits (P = 0.5624) did not differ significantly between the two groups. Patients who switched more than once experienced a significant increase in hospital visits (P = 0.0061) and hospital visits due to cardiovascular disease (P = 0.0096) compared to non-switchers. Difference-in-differences in outpatient healthcare utilisation did not differ between non-switchers and switchers. Total savings resulting from the policy change ranged from <euro> 94.4 million to <euro> 108.7 million. Although manufacturers usually comply with reference pricing by reducing their retail prices to the reference price, regulators have to be aware of the consequences in cases where manufacturers react as in this situation.
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