The concept of value-based healthcare: opportunities for drug pricing


V.A. Lemeshko(1, 2), N.Z. Musina(1, 3) 1-Center of Healthcare Expertise and Quality Control, Ministry of Health of the Russian Federation, 10, Khokhlovsky Lane, Build. 5, Moscow 109028, Russian Federation; 2-I.M. Sechenov First Moscow State Medical University (Sechenov University), 8, Trubetskaya St., Build. 2, Moscow119991, Russian Federation; 3-Saint Petersburg State Chemical Pharmaceutical University, 14, Prof. Popov St., Saint Petersburg 197376, Russian Federation

The paper reviews methodological approaches to value-based pricing (VBP), within which the principles of determining the values of drugs and converting the resulting value into a price. At the value determination stage, the investigators identify two main approaches: 1) to use the indicator the number of years of life in terms of its quality (quality-adjusted life-year (QALY)) as a value criterion and 2) to determine multicriteria values. On this evidence, an approach to calculating the drug price is subsequently determined. The classic approach is to use the cost-effectiveness analysis and the established willingness-to-pay threshold for an additional QALY; however, it does not make it possible to take into account all aspects of value and requires that cost-effectiveness should be used as the main driver in making a reimbursement decision. The alternative approaches are to determine the willingness to pay per unit of aggregate value (taking into account multiple criteria) using the net monetary benefit method or establishing a premium system in terms of a drug’s value level. Currently, only the United Kingdom fully uses cost-effective VBP, while other countries employ its elements.

value-based pricing
quality-adjusted life years
multicriteria decision making analysis

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