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Issues for countries considering introducing the “fourth hurdle”: The case of Hungary

Published online by Cambridge University Press:  01 August 2004

László Gulácsi ,
Imre Boncz  and
Michael Drummond
László Gulácsi
Affiliation:
Budapest University of Economic Sciences and Public Administration
Imre Boncz
Affiliation:
National Health Insurance Fund Administration
Michael Drummond
Affiliation:
University of York
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Abstract

Objectives: This study outlines the needs and current development of the “fourth hurdle” (i.e., requirement of effectiveness and cost-effectiveness data for drug coverage policy decisions) in Hungary, describes the legal background and seeks to address some of the most important questions in this field.

Methods: The study draws on international experiences and discusses five issues that a given jurisdiction needs to consider before introducing the “fourth hurdle” for pharmaceuticals.

Results: The “fourth hurdle” is very relevant in Hungary because many existing drugs are unevaluated and many new, expensive drugs are becoming available. On the other hand, the existing resources for health technology assessment, including economic evaluation, are quite limited. All the five issues are relevant in the Hungarian setting and were helpful in determining exactly how the “fourth hurdle” should be applied.

Conclusions: The most important issue seems to be that the implementation of the “fourth hurdle” needs to be achieved in a way consistent with the limited resources for HTA in Hungary. Specifically this means that, in setting priorities for drugs to evaluate, additional criteria need to be applied. In particular, priority should be given to assessing drugs that have been evaluated in other countries, because this affords the opportunity to adapt existing studies or models to the Hungarian situation.

Keywords

DrugFourth hurdleEffectivenessCost-effectivenessHungary
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 3 , August 2004 , pp. 337 - 341
Copyright
© 2004 Cambridge University Press

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References

Anon A. 2002. UK risk-sharing deal for MS products. Scrip No 2718, February 6, 2002. Richmond: PJB Publications: 2.
Buxton M. Cost-effectiveness and guidance: Lessons from NICE 3 years on. Presentation to ISPOR 5th Annual European Conference, Rotterdam; November 4, 2002.
Drummond MF. 1992 Basing prescription drug payment on economic analysis: The case of Australia. Health Aff (Millwood). 11: 191– 196.Google Scholar
Drummond M. 2002 Time for change in drug licensing requirements? Eur J Health Econ. 3: 137– 138.Google Scholar
Drummond M. 2003 Will there ever be a European drug pricing and reimbursement agency? Eur J Health Econ. 4: 67– 69.Google Scholar
Gulácsi L, David T, Dózsa Cs. 2002 Pricing and reimbursement of drugs and medical devices in Hungary. Eur J Health Econ. 3: 271– 278.Google Scholar
Henry D, 1992 Economic analysis as an aid to subsidisation decisions: The development of the Australian guidelines for pharmaceuticals. Pharmacoeconomics. 1: 54– 67.Google Scholar
Hill SR, Mitchell AS, Henry DA. 2000 Problems with the interpretation of pharmacoeconomic analyses. A review of submission to the Australian pharmaceutical benefits scheme. JAMA. 283: 2116– 2121.Google Scholar
Hutton J. European level cost-effectiveness analysis as a basis for reimbursement of drugs: Policy breakthrough or unattainable. DIA Euro Meeting, Rome, March 6, 2003.
Lohr KN, Eleazer K, Mauskopf J. 1998 Health policy issues and applications for evidence based medicine and clinical practice guidelines. Health Policy. 46: 1– 19.Google Scholar
Budapest Ministry of Health, Social and Family Affairs. 2002 Budapest methodological guidelines for conducting economic evaluation of health care interventions in Hungary. J Ministry Health Soc Family Affairs. 52: 1314– 1334.
Oortwijn W, Vondeling H, Barneveld T, et al. 2002 Priority setting for health technology assessment in the Netherlands: Principles and practice. Health Policy. 62: 227– 242.Google Scholar
Revicki DA, Frank L. 1999 Pharmacoeconomic evaluation in the real world. Pharmacoeconomics. 15: 423– 434.Google Scholar
Rutten F, Gulácsi L. 2002 Using economic evaluation in health policy: Options for health care systems in transition. Eur J Health Econ. (Suppl 1): S8– S9.Google Scholar
Shani S, Siebzehner MI, Luxenburg O. 2000 Setting priorities for the adoption of health technologies on a national level: The Israeli experience. Health Policy. 54: 169– 185.Google Scholar
Sketris IS, Hill S. 1998 The Australian national publicly subsidised pharmaceutical benefit scheme: Any lesson for Canada? Can J Clin Pharmacol. 5: 111– 118.Google Scholar
Hungarian Ministry of Health. 2001. The National Public Health Programme 2001–2010. Budapest: Ministry of Health