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• The macroeconomic possibilities of biosimilars in developed countries

  3-18

  Peter Halmosi

  Views:

  182

  Biosimilars have been used for the treatment of chronic diseases since 2006 in the EU but only since 2015 in the U.S. Despite high market potentials and presumed positive macroeconomic effects in the health care sector, widespread usage is strongly confronted with the opposition of physicians and pharmacists. However, biosimilars are supposed to reform health care financing, alter market positions of pharmaceutical companies and amend informational triangle among physicians, patients and insurance companies in the near future. The use of biosimilars is supposed by experts to reach extra health related savings even if doctors and pharmacists are averse to offer these products to patients in a certain therapeutic area. Governments have currently found no unique way of regulating the marketing, substitution and price regulation of biosimilars. The aim of this study is to discuss the macroeconomic possibilities and barriers incarnated in the usage of biosimilars in developed countries.

  Journal of Economic Literature (JEL) codes: H51, I11, I12, J18

• Implementing Risk Adjusted Capitation Payments with Health Care Reforms in Hung

  147-160

  Balazs Nagy

  Agnes Brandtmüller

  Views:

  177

  Since the late nineties Hungarian governments have been considering the introduction of new health care arrangements by establishing organizations with devolved responsibilities for the management of health care. These organizations are typically financed through a weighted (risk adjusted) capitation system which is regarded as an adequate and optimal tool for resource allocation purposes. Through capitation one needs to handle large inequities in the Hungarian health care system and keep an eye on the incentives for efficiency. For the capitation formula a relatively broad choice of risk adjusters are available in the form of pharmacy- and diagnosis-based patient level utilization data (health-based adjusters) and area level socio-economic data (non health-based adjusters). The instant application of health-based adjusters has limitations because they reflect a distorted provider structure and offer perverse incentives; therefore a gradual shift from using non health-based adjusters to health-based adjusters is preferred. The early phase of the capitation system also implies a strong presence of risk sharing arrangements and other complementary policies. Given that promoting efficiency and equity are to be pursued, the capitation approach outlined in this paper should serve as a guide to future Hungarian health care system reforms.

  Journal of Economic Literature (JEL) code: I28, G28, G32, H51