Pricing controls are a growing feature of the BRIC/MIST landscape.
Regulatory pricing controls are being stepped up in countries where governments are subsidizing a growing share of overall drug costs, or have announced plans to do so. Generally, rates of change in pharmaceutical coverage determine the pace and extent of pricing reforms. Accordingly, some of the most fundamental (and problematic) reforms encountered by manufacturers in recent years have been implemented in Turkey, where the government has taken on much broader responsibility for healthcare provision and funding.
Elsewhere, major changes are being implemented in China, where new pricing rules will have a fundamental impact not only on new drug prices but also on those of older original brands and generics. Substantive pricing reforms are also expected to accompany the establishment of a universal outpatient drug benefits scheme in Russia. Financial issues appear certain to delay the rollout of that initiative, however, and its full impact on pricing policy may not become clear for several years.
While tighter pricing controls are generally being imposed as governments foot a growing proportion of the drug spending bill, India is a notable exception. There, successive governments have failed to deliver on expansive health insurance coverage pledges, leaving most patients to foot the vast majority of their pharmaceutical costs. Nevertheless, a shift towards more widespread regulatory control of drug prices has been witnessed since 2012, and the imposition of additional measures – possibly including explicit controls on patented drug prices – is being discussed.
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