Croatia's HZZO has added several new innovative oncology medicines to the reimbursement list, among many new additions of innovative medicines and indications.
IHS Life Sciences perspective | |
Implications | The announcement by the HZZO of the new additions to the reimbursement list underlines its ongoing commitment to improving access to new innovative treatments. |
Outlook | The HZZO has confirmed a significant increase in spending on high-cost medicines in 2015, even as overall drug reimbursement spending declines. |
The governing council of the Croatian Health Insurance Fund (HZZO) announced the addition of a number of new innovative medicines to its reimbursement list, as well as a number of new indications for innovative medicines already on the list, at its 94th regular session on 23 October. The new additions are listed in the table below, based on the HZZO's press release.
New innovative medicines/indications added to HZZO reimbursement list, October 2014 | ||
Medicines included for the first time on HZZO's reimbursement list | ||
Name of medicine | Producer | Indication(s)/treatment area |
Revolade (eltrombopag) | Novartis (Switzerland) | Idiopathic thrombocytopenic purpura |
Sivextro (tedizolid phosphate) | Merck & Co (US) | Treatment of bacterial skin infections |
Rezolsta (darunavir + cobicistat) | Janssen-Cilag (subsidiary of US pharma major Johnson & Johnson) | HIV/AIDS |
Harvoni (sofosbuvir + ledipasvir) | Gilead Sciences (US) | Chronic hepatitis C |
Levact (bendamustine) | Mundipharma (UK) | Chronic lymphocytic leukaemia and non-Hodgkin lymphoma |
Perjeta (pertuzumab) | Roche (Switzerland) | Metastatic breast cancer |
Adcetris (brentuximab vedotin) | Takeda (Japan) | Lymphoma |
Xalkori (crizotinib) | Pfizer (US) | ALK-positive lung cancer |
Tafinlar (dabrafenib) | GlaxoSmithKline (GSK, UK) | Melanoma |
Lynparza (olaparib) | AstraZeneca (UK) | BRCA-positive ovarian cancer |
New indications for innovative medicines already on the HZZO's reimbursement lists | ||
Cimzia (certolizumab pegol) | UCB Pharma (Belgium) | Arthritis |
Xgeva (denosumab)* | Amgen (US) | Bone metastases secondary to solid tumours |
Votrient (pazopanib) | GSK | Soft tissue sarcoma |
Erbitux (cetuximab) | Merck Serono | Squamous cell carcinoma of the head and neck |
Sources: HZZO, Cybermed *Denosumab previously reimbursed under brand name Prolia for treatment of osteoporosis. | ||
Some newly reimbursement innovative medicines subject to new "payment-by-result" contracts
The HZZO states in its press release that a number of the new innovative medicines will be subject to a new model of reimbursement contract, which is based on payment by results. The HZZO states that in the case of Harvoni, Perjeta, Xalkori, and Lynparza, 'additional' reimbursement will be dependent on whether treatment is effective. However, there are no precise details provided on how these contracts are structured.
Outlook and implications
The idea of a payment-by-results system was first put forward by the HZZO when it announced in July the addition of several other interferon-free medicines for the treatment of chronic hepatitis C to the reimbursement list (see Croatia: 30 July 2015: HZZO to add interferon-free HCV and prostate cancer drugs to Croatia's basic reimbursement list, proposes payment-by-results system). The introduction of a similar system in Romania indicates a regional trend for such arrangements, materialising around the same time as the appearance of the Gilead Sciences (US) chronic hepatitis C drug Sovaldi (sofosbuvir).
The addition of these new innovative medicines and indications shows increased emphasis on funding new innovative treatments in Croatia. Although some of the drugs concerned were approved for marketing in the European Union some years ago, an increasing number of new innovative medicines or indication extensions of existing medicines are being added to the Croatian reimbursement list sooner than was the case in the past. This underlines the importance of increasing spending on high-cost medicines in Croatia, even as overall expenditure on drug reimbursement is decreasing (see Croatia: 12 October 2015: Croatia's health insurance fund declares 30% y/y increase in spending on biologics in 2015).