Pharma Pricing and Reimbursement and Market Access Risk Scores (MARS) Outlook 2022-2023

The pharma pricing and reimbursement (P&R) and market access risk report provide an executive summary of healthcare expenditure and pharmaceutical sales forecasts from its Q1 2023 forecast cycle. The global market access risk score (MARS) has significantly increased in the first quarter of 2023 while remaining at an elevated risk level of 2.371. 2023 sees an increasing standoff between the pharma industry and the government. As governments look to address budget deficits and inflation, the pharma sector has been targeted as a profitable industry even during the COVID-19 pandemic.

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Pharma Pricing and Reimbursement and Market Access Risk Scores (MARS) FAQs

  • What was the market access risk score for Q1 2023?
    The global market access risk score (MARS) has significantly increased in the first quarter of 2023 while remaining at an elevated risk level of 2.371.
  • What was the reason behind Latin America’s improved market access?
    Latin America’s improved market access was the result of some countries lifting price caps and applying changes to reimbursement mechanisms in 2022.
  • Which key event had a positive effect on market access in 2022?

The introduction of a new cost-effectiveness threshold for orphan drugs and advanced therapies due to Slovakia’s major P&R reforms had a positive effect on market access in 2022.

  • Which key event had a negative effect on market access in 2022?

The burden shift from clawbacks to rebates due to Greek MoH Bill had a negative effect on market access in 2022.

 

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Pharma Pricing and Reimbursement and Market Access Risk Scores (MARS) Highlights

  • The pharma pricing and reimbursement (P&R) and market access risk report provide an executive summary of healthcare expenditure and pharmaceutical sales forecasts from its Q1 2023 forecast cycle. For this quarterly update, GlobalData has updated the events risk ratings for the past 3 months captured in our qualitative measures, along with macroeconomic, political, legal environment, demographic and social structure effectiveness, technology and infrastructure, and environment risks. These factors are reflected in the quantitative measures. GlobalData has also included a look back at the key pricing and market access trends of 2022 and how they will define the outlook of the pharma industry in 2023.
  • The efforts to safeguard medicines supplies will continue, and some advanced markets are likely to offer pricing and reimbursement incentives to domestically produced medicines. Such small instances of pricing and reimbursement flexibility will be balanced by efforts to secure pharmaceutical savings in other areas.
  • For example, initiatives in the US include boosting the use of biosimilars (with one major health plan already announcing plans to add biosimilar Humira to its formulary), and direct government price negotiation (the first in US history) of selected Medicare medicines under the Inflation Reduction Act.
  • The year 2023 will continue to see price hikes in response to the ongoing drug shortages due to the Russia-Ukraine conflict, rising inflation rates, and increased cost of manufacturing. Countries such as Turkey, Greece, and Germany have already begun placing measures to incentive generics or apply downward pressure on the prices of branded medicines.

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Pharma Pricing and Reimbursement and Market Access Risk – Regional Overview

The key regions considered for pharma pricing and reimbursement and market access risk are Latin America, North America, Europe, Asia-Pacific, and Middle East & Africa.

Latin America: Latin America’s improved market access was the result of some countries lifting price caps and applying changes to reimbursement mechanisms in 2022. Although these markets are maturing, the regulations put in place also tackle inflationary pressure and shortages brought about due to the war in Ukraine.

North America: In the US, pressure to control prescription drug prices has resulted in the passing of the Inflation Reduction Act, marking the first time the federal government could negotiate prices. However, in Canada, the passing of the Patented Medicine Prices Review Board (PMPRB) reforms and their ongoing effects have caused concerns over drug availability.

Europe: Many European markets in 2022 have applied significant pressure to the pharma industry in the form of cost containment measures, leading the industry to question the strength of key markets such as the UK and Germany.

Asia-Pacific: The Asia-Pacific markets continued to face challenges around pricing pressure, inflationary pressure, and drug shortages. Except for China’s expansion of essential pediatric medicine, 2022 was marked by key adjustments in the form of price controls and prolonged discussion over Japan’s pricing reform, including highly negative new “off year” price reductions.

Middle East & Africa: The Middle East & African markets saw significant changes to pricing strategies in 2022. Price hikes, reimbursement expansions, and steep changes to healthcare budgets all looked to aid market conditions against rising import costs and inflation.

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