Analysis of medical service units and prices of traditional Chinese medicine in the Yangtze River Delta / 中华医院管理杂志

Objective:To compare and analyze the pricing units and prices of traditional Chinese medicine (TCM) medical services in 4 provinces of the Yangtze River Delta, for reference for the integrated development of TCM medical service project setting and price coordination in the Yangtze River Delta region.Methods:The medical service price project specifications published on the official websites of relevant departments in 4 provinces of the Yangtze River Delta (updated to March 2022) were obtained to extract data such as project names and pricing units. The pricing units and prices of TCM medical service projects in each province were compared and analyzed; The Jevons index method was used to analyze comparable project prices.Results:The numbers of TCM medical service projects in Shanghai, Jiangsu, Zhejiang, and Anhui were 113, 146, 117, and 198, respectively. The types of pricing units were 15, 24, 13, and 12, respectively. There were differences in the setting of pricing units, especially in acupuncture and moxibustion, which had more decomposition projects. The average price of overall medical services in the Yangtze River Delta was 9.81 times that of TCM medical services. There were differences in the prices of comparable TCM medical service projects among the four provinces. Based on Anhui province, the inter provincial Jevons index of other categories of TCM medical service projects except for TCM massage were all less than 1.00.Conclusions:There were significant differences in the pricing units and prices of TCM medical service projects in the four provinces of the Yangtze River Delta, with Anhui province having the most significant difference compared to the other three provinces; The overall price of TCM medical service projects was relatively low.

International Price Comparisons of Anticancer Drugs: A Scheme for Improving Patient Accessibility.

BACKGROUND: The demand for implementing a new listing scheme to expedite patient access to novel oncology drugs has increased in South Korea. This study was conducted to compare the prices of anticancer drugs between eight countries and to explore the feasibility of a 'pre-listing and post-evaluation' scheme to expedite patient access to oncology drugs. METHODS: This study included 34 anticancer drugs, which were reimbursed between 1 January 2007 and 31 December 2017. The unit price and sales volume of the study drugs were collected from eight countries and IQVIA data, respectively. The prices were adjusted to estimate the ex-factory prices using the discount/rebate rate suggested by the Health Insurance Review Agency (HIRA). The four price indices of Laspeyres, Paasche, Fisher, and the unweighted index were calculated using the price in each country, the average price, and lowest price among the study countries. Each currency was converted using the currency exchange rate and purchasing power parity (PPP). The budget impact of implementing the proposed pre-listing and post-evaluation scheme on payers was calculated. RESULTS: Based on the currency exchange rate, anticancer drug prices were higher in other countries (index range: 1.05-2.78) compared to Korea. The prices in Korea were similar to countries with the lowest prices. When the PPP was applied, prices were higher in the US, Germany, Italy, and Japan than in Korea (range: 1.10-2.13); however, the prices were lower in the UK, France, and Switzerland than in Korea (range: 0.72-0.99). The financial burden of implementing the pre-listing and post-evaluation scheme was calculated at 0.83% of the total anticancer drug sales value in Korea from 2013-2017. CONCLUSIONS: The prices of anticancer drugs in Korea were similar to the lowest prices among the seven other study countries. A pre-listing and post-evaluation scheme should be considered to improve patient access to novel anticancer drugs by reducing the reimbursement review time and uncertainties.

Comparing the effectiveness of two app-based number lines to teach price comparison to students with autism spectrum disorders.

PURPOSE: A number line consisting of Arabic numerals is a commonly used instructional tool for teaching price comparison. However, typical number lines lack concrete visual cues, which may benefit students with autism spectrum disorders (ASD) who have not yet mastered the representation of Arabic numerals. METHOD: This study investigated the effects of additional visual cues (i.e., dots) by comparing two types of app-based number line conditions: number lines with and without dots. A single-subject, alternating treatment design study was employed across five secondary students with ASD. RESULTS: Both number line conditions were effective for four of the students in assisting them to select cheaper items and complete task analysis steps. The number line with dots was effective or slightly more effective in selecting smaller numbers for three of the students. CONCLUSIONS: The findings of this study support the literature on the use of number lines as an effective tool to assist students in price comparison. The benefits of adding concrete visual cues and other teaching strategies (e.g., the holistic and decomposition models) were discussed. Implications for Rehabilitation This study investigated the effectiveness of concrete visual cues, such as dots, on a number line app for teaching students with ASD who had not yet developed the association of quantities with the numerals. We found that incorporation of a hybrid number comparison model - first holistic (for whole numbers) and then decomposition (for numbers after the decimal point) - is effective when teaching students how to compare prices with an uneven number of digits. This study provides an alternative for special education teachers to schedule practice, such as the use of simulated settings to achieve mastery, then transitioning to community-based settings to test skill generalization.

Comparing a number line and audio prompts in supporting price comparison by students with intellectual disability.

BACKGROUND/AIMS/METHODS: Price comparison is an important and complex skill, but it lacks sufficient research attention in terms of educating secondary students with intellectual disability and/or autism spectrum disorder. This alternating treatment design study compared the use of a paper-based number line and audio prompts delivered via an audio recorder to support three secondary students with intellectual disability to independently and accuracy compare the price of three separate grocery items. PROCEDURES/OUTCOMES: The study consisted of 22 sessions, spread across baseline, intervention, best treatment, and two different generalization phases. Data were collected on the percent of task analysis steps completed independently, the type of prompts needed, students' accuracy selecting the lowest priced item, and task completion time. RESULTS/CONCLUSIONS: With both intervention conditions, students were able to independently complete the task analysis steps as well as accurately select the lowest priced item and decrease their task completion time. For two of the students, the audio recorder condition resulted in the greatest independence and for one the number line. For only one student was the condition with the greatest independence also the condition for the highest rate of accuracy. IMPLICATIONS: The results suggest both tools can support students with price comparison. Yet, audio recorders offer students and teachers an age-appropriate and setting-appropriate option.

Comment on the implications of external price referencing of pharmaceuticals in Middle East countries.

External Price Referencing (EPR) is frequently used by countries to control pharmaceutical prices but studies to substantiate its use in the Middle East (ME) is lacking. The paper by Kalo et al set-out to fill this lacuna through three objectives: i) to document the use of EPR in 7 ME countries, ii) to assess whether pharmaceutical EPR resulted in a narrow price corridor for patented pharmaceuticals, and iii) to analyse factors influencing pharmaceutical prices. This comment discusses why the paper fell short of achieving these objectives and over-stated the results. Despite a thought-provoking contribution, objective 1 presented few new insights on EPR mechanisms, objective 2 deployed an inappropriate research design, and the policy implications of objective 3 are voided given the choice of explanatory variables.

Implications of external price referencing of pharmaceuticals in Middle East countries.

INTRODUCTION: External price referencing (EPR) is applied frequently to control pharmaceutical prices. Our objective was to analyse how EPR is used in Middle Eastern (ME) countries and to compare the price corridor for original pharmaceuticals to non-pharmaceutical services not subjected to EPR. METHODS: We conducted a survey on EPR regulations and collected prices of 16 patented pharmaceuticals and 14 non-pharmaceutical services in seven Middle Eastern (ME) countries. Maximum and minimum prices of each pharmaceutical and non-pharmaceutical technology were compared to mean prices in the countries studied by using market exchange rates. Influencing factors of pharmaceutical prices were assessed by multivariate linear regression analysis. RESULTS: The average price corridor is narrower for pharmaceuticals (-39.8%; +35.9%) than for outpatient and hospital services (-81.7%; +96.3%). CONCLUSION: Our analysis revealed the importance of population size and EPR implementation on drug price levels; however, EPR results in higher pharmaceutical prices in lower-income countries compared to non-pharmaceutical services.

Development of price comparison method system for Shanghai's medical service pricing / 中华医院管理杂志

The paper reviewed the medical service pricing at home and abroad and progress in the price comparison system,and introduced the price comparison system of Shanghai's medical services. Proposals in the paper include building the price parameters fitting local conditions,and setting prices using the standardized price model;forming a comprehensive price adjustment scheme with reference to international price comparison relations and domestic pricing level; upgrading the fine pricing management level of medical service pricing and improving charging management dimensions;enhancing interactions and assessment of price-related departments to guide public hospitals to enhance.

Is Europe still heading to a common price level for on-patent medicines? An exploratory study among 15 Western European countries.

BACKGROUND: Previous studies have suggested that medicines prices in Europe converge over time as a result of policy measures such as external price referencing. OBJECTIVE: To explore whether ex-factory prices of on-patented medicines in Western European countries have converged over a recent period of time. METHODS: Prices of ten on-patent medicines in five years (2007, 2008, 2010, 2011, 2012) of 15 European countries were analyzed. The unit of analysis was the ex-factory price in Euro per defined daily dose (exchange rate indexed to 2007). A score (deviation from the average price) per country as well as the ranges were calculated for all medicines. RESULTS: The prices between countries and selected products varied to a great extent from as low as an average price of € 1.3/DDD for sitagliptin in 2010-2012 to an average of € 221.5/DDD for alemtuzumab in 2011. Between 2008 and 2012, a price divergence was seen which was fully driven by two countries, Germany (up to 27% more expensive than the average) and Greece (up to 32% cheaper than the average). All other countries had stable prices and centered around the country average. Prices of less expensive as well as expensive medicines remained relatively stable or decreased over time, while only the price of sirolimus relatively increased. CONCLUSIONS: Our study period included the time of the recession and several pricing policy measures may have affected the prices of medicines. Instead of the expected price convergence we observed a price divergence driven by price changes in only two of the 15 countries. All other European countries remained stable around the country average. Further research is needed to expand the study to a bigger sample size, and include prescribing data and Eastern European countries.