Value based pricing-part-2

Welcome to my value-based pricing-part-2. 1948 on the establishment of NHS (national health service, NHS) is the earliest a universal health care system (universal healthcare systems) of a single national insurance (national insurance contribution) to include tax operating and other-other European countries than me more has tinged the centralized (centralized system) format. Over the past decades, the United Kingdom (England) in market reforms (market reforms) through private health providers (private providers) have introduced the public sector, mainly through the funding provided is being operated.

At the time of 1999 health care devolution (devolution), NHS England, on the other hand that accelerate the internal market (internal market), Northern Ireland and Scotland, and Wales between types of buyers (purchasers) and health care providers similar to the UK (providers) It did not perform the separation.

NHS England primary care (primary care) and very specialized services (highly specialized services) directly to the delegation was "clinically delegation group (clinical commissioning groups, CCGs) 'oversight and resource allocation to these; CCG will work with General (general practice) in order to plan, design and by the local health services (local health services). Since devolution NHS reforms are regularly picked to run the most recent reforms of the 2012 'Health and Social Care Act (Health and Social Care Act)' it is. Physician healthcare services commissioned officer in the design of a law of 152 primary care trusts (primary care trust) and the delegate specialized groups (specialized commissioning group) and 211 were replaced by CCG. Recent health care services more effectively pursue the quality innovation, productivity and prevention (Quality Innovation and Productivity and Prevention)' action plan (initiative) have been made. This enables savings of 200 billion pounds (about 32 billion) from 2014-15 and is blamed for poor patient care (poor patient care), with severe pressure on NHS trusts poured.

UK Health Technology Assessment (health technology appraisal) structure permissions to about accountability, institutional, classification and pharmaceutical and medical device monitoring aspects in three separate institutions to configure gotta have MPEG (Department of Health Medicines, Pharmacy and Industry Group), NICE (National Institute for Health together with Care Excellence). NIHR  (National Institute for Health Research). The UK is a separate reimbursement and pricing mechanism is not European medicine treatment (European Medicines Agency, EMA) or  medicines and healthcare manufacture Regulatory Regulatory Agency (Medicines and Healthcare products Regulatory Agency, MHRA)' The licensing approval and NICE or NHS If England is approved for use, Ministry of Health (Department of Health) should approve the full benefits and determine the prices for most new prescription drugs for outpatient and inpatient sectors.

NHS England has the more growing role in NICE's evaluation and prescription drugs (specialist medicines) are not evaluated. 90% of the outpatient prescription standard fixed cost (standard, fixed prescription charge) paid to age, medical condition or income is exempt in accordance with the prescription items are dispensed free of charge 8.2 pounds. In some cases, hospitals may purchase a discounted amount of NHS medicines listed price (list price).

Regulate the reimbursement and pricing decisions and the NHS listed price (list price)

· Brand prescription drugs (branded prescription medicines) Prices drug price regulatory regime (Pharmaceutical Price Regulation Scheme, PPRS) in by controlled and, Ministry of Health (Department of Health) and the NHS to supply that inpatient branded pharmaceuticals (NHS drug expenditures of 70 %) as determined by a voluntary agreement (voluntary agreement) between the Association of the British pharmaceutical representing manufacturers

· Drug Tariff (Drug Tariff) is a generic drug (generic medicines) determines the insurance price: generic medicines in the UK show a high market share (67%)

The most influential institutions in the technical evaluation was established in 1999, there are two main roles: NICE technology assessment (technology appraisal) will present the prescription drug approval and related recommendations (recommendations) and evidence-based guidelines on a variety of topics ( evidence-based guidelines) - also presented - a wide range of services and interventions (intervention) plan from prevention and control of certain diseases

· It is corrected one (quality-adjusted life year, QALYs) as a measure of cost-effectiveness threshold value (cost-effectiveness threshold) operations, and typically 20,000-30,000 per QALY pounds of costs does not recommendations. End of life (end of life) if the threshold value of patient up to 50,000 pounds per QALY

· Do the NHS NICE is by law required to provide insurance benefits within 90 days for a doctor decides drugs

Britain has long been "value-based health care `` There has been a leading position among European countries working to expand the use. Many European policymakers have and make the UK NICE as a model. Recent NHS England has a variety of 'performance-based pay (pay-for-performance)' model experiments and, with inefficient shown care and treatment paths (care and treatment pathways) of the localized deviations (localized variation) to identify and remove to order sought has been. However, the structural health care reform over the years is that you can increase the value of real money the UK to a certain extent (value for money) creating a segmented system (fragmented system) hit pinch the impact of deepening morale care providers is unclear as to whether the situation even to determine the value.

Has a comprehensive system for the measurement of cost-effectiveness in drug and technology that NICE is running, but the definition of value (value) (definition) is still a "moving target (moving target) 'state. Plan of the past five years to understand that the "value-based pricing  'can be introduced to a new form of drug evaluation and has sought to clarify. Policymakers have introduced a variety of "performance-based compensation (pay-for-performance, P4P) 'it means in different areas of the NHS over the decades. Primary Health Care in the 'quality and outcomes framework (Quality and Outcomes Framework, QOF)' and secondary health care in the "Best Operating Tariff (Best Practice Tariffs, BPTs) 'to include to evidence-based methods applied to for incentives to offer to If possible, it was introduced was to reduce the unnecessary use of expensive interventions (interventions). To remove inequalities (inequity) confirmed the variation in the way of changing the care delivery path and a separate approach. In addition, by modifying the value NICE threshold value has been expended in the effort to consider a wide range of factors than to assist in decision making. QOF evaluates the general surgery (general practitioner (GP) surgery) as a result of compensation (reward) and incentive programs offered each year. General to introduced as part of the contract of General in 2004 to standardize the preventive improvement measures executed, such as diabetes and chronic diseases such as asthma, public health issues such as smoking and obesity, blood pressure management and provide high-quality care and to provide an incentive. In 2009 the British government 'quality and innovation delegation (Commissioning for Quality and Innovation, CQUIN)' action plan introduced by healthcare providers in income areas of quality and improvement goals if the connection to excellent care to for compensation to have. CQUIN has a national and regional target and care should look the clinical effectiveness and cost-effectiveness by introducing an additional BPT and tariffs (tariffs) will help to improve quality by reducing the deviation NHS does not achieve a productivity explanation It was designed to. However, a clear assessment of the success of this measure is that there P4P P4P plans are being challenged in the process and the quality of care based on performance showed an improvement effect will be limited. In addition to promoting the quality and productivity improvement through financial incentives to healthcare innovators, we have paid great efforts to improve the performance variation across the country. Inappropriate regional variations identified in a recent study were as follows; 1) damage to the patient due to excessive diagnosis and over-treatment: even Even in high-quality treatment applied (for example, the lifetime of chemotherapy in the last point, hangsaengjae or hospital mortality), 2) a particular social group (eg, buttocks pierced replacement surgery injustice (inequity) of the health care system due to insufficient utilization (underuse) of health care services of high value due to the patients), and the more valuable when 3) used for the treatment or other patients that do not provide added value to patients capable of providing waste (waste).

Government proposals for value-based pricing were first introduced by the nonprofit consumer protection organization to close its doors in 2014, Fair Trade organizations (Office of Fair Trading) 'in 2007 made a more explicit by the year PPRS 2009 lost. In 2013, NICE is new for executing value-based assessment Mandate (terms of reference) the adoption was more extensive on the value that holds the disease burden (burden of illness) and wider social benefits (societal benefits) in the evaluation It creates a definition. More transparent the planned new approach to cost-benefit decisions that run in August 2014 and initially was designed to be consistent and predictable.

In general, NICE assessed the medicine of the 1/3 less than the about negative Directive (negative guidance) make recommendations, but these decisions are politically challenging as 2009 PPRS scheme 'patient access scheme (patient access scheme, PAS)' known including provisions pharmaceutical companies had to negotiate lower prices for medicines by NICE rejected. While the kidney cancer drug is rejected by NICE in 2009 requires the government to apply less stringent criteria for the end of life drugs (end-of-life drugs) overturned the NICE decision. The patient accessibility operating system was approved by a significant increase in health institutions accessibility Castle 48 cases of patients in 2015. Many of them have applied a simple price reduction procedures. In 2010, drug accessibility to reject been a patient of the media campaign amid government anticancer Fund (cancer drugs fund, CDF) to arrange in March 2016 operating plan as NICE is still under review do not have or denied drugs to fund the composition to as were initial annual budget of 2 billion pounds (about 3,200 million). The budget was increased to 280 million pounds in 2014-15 (about 4,480 million), 3.4 billion pounds in 2015-16 (about 5,440 million).

In recent years, the UK government to eliminate the cost and benefit analysis for some drugs cause the NHS England to negotiate prices with pharmaceutical companies. However, in February 2016, Congress had publicly blamed for the sexual health of NHS England anticancer Fund Management argued that the government is still thinking about the benefits that patients get from the fund. Health castle was held to introduce value-based pricing plans NHS expenditure on branded medicines instead of to negotiate the current PPRS scheme was limited to spending increase or decrease of less than 2% over the next three years without change during 2013-15 (cap).
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