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Reimbursement prices of new, innovative medicines in Germany: a comparison of negotiation and cost-effectiveness analysis

Afschin Gandjour

Health Economics, Policy and Law2025https://doi.org/10.1017/s1744133124000288article
ABDC B
Weight
0.44

Abstract

This study aimed to compare reimbursement prices for new, innovative non-orphan drugs in Germany based on price negotiation and cost-effectiveness analysis, using the efficiency frontier (EF) approach and cost-utility analysis (CUA). For the EF, the next effective intervention and no intervention were used as comparators. Three pairwise comparisons were conducted: negotiation vs EF, CUA vs EF and negotiation vs CUA. For the comparison between negotiation and EF, relative risk reductions for a given added health benefit were assigned, and resulting price premiums were determined using an empirical estimate from the literature and a conceptual model. The difference between CUA vs EF was determined based on an aggregation rule and thresholds for CUA based on the average and marginal cost-effectiveness of the health care system. The difference between negotiation and CUA was determined through an indirect comparison. Price premiums based on negotiation are approximately 10-40 per cent higher than those based on EF using no intervention as a comparator. Furthermore, price premiums based on CUA (threshold at system-average cost-effectiveness) are approximately 25-50 per cent higher than those based on EF using no intervention as a comparator. The indirect comparison predicts that price premiums based on CUA (threshold at system-average cost-effectiveness) are approximately 10-15 per cent higher than those based on negotiation. For a threshold set at system-marginal cost-effectiveness, price premiums based on CUA are more than threefold higher than those based on negotiation. In the German health care system, CUA with a threshold set at system-average or system-marginal cost-effectiveness is predicted to yield higher reimbursement prices than price negotiations or the EF approach based on no intervention as a comparator.

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https://doi.org/https://doi.org/10.1017/s1744133124000288

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@article{afschin2025,
  title        = {{Reimbursement prices of new, innovative medicines in Germany: a comparison of negotiation and cost-effectiveness analysis}},
  author       = {Afschin Gandjour},
  journal      = {Health Economics, Policy and Law},
  year         = {2025},
  doi          = {https://doi.org/https://doi.org/10.1017/s1744133124000288},
}

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Evidence weight

0.44

Balanced mode · F 0.40 / M 0.15 / V 0.05 / R 0.40

F · citation impact0.32 × 0.4 = 0.13
M · momentum0.57 × 0.15 = 0.09
V · venue signal0.50 × 0.05 = 0.03
R · text relevance †0.50 × 0.4 = 0.20

† Text relevance is estimated at 0.50 on the detail page — for your query’s actual relevance score, open this paper from a search result.