1. Estimation of AnTC of the appraised pharmaceutical after negotiation: | |
Average annual tablet consumption according to the decision of the FJC: 730–1460 | |
Package size: 56 tablets | |
Annual package consumption: [(730 + 1460)/2]56 = 19.5536 | |
Additional SHI services or other SHI costs: 0 € | |
Date of FJC decisdion: March 2013 âž” search for price adaptation in German Drug Directory (Lauer) September/October 2013 | |
Date of new price for Inlyta 5 mg 56 tabl.: 01.10.2013 | |
Pharmacy selling price (PSP): 5596.87 € | |
Mandatory pharmacy rebate: 1.85 € | |
Mandatory manufacturer rebate: 1941.53 € | |
Costs after subtraction of statutory mandated rebates: 5596.87–1.85 – 1941.53 = 3653.49 € | |
AnTC after negotiation = 3653.49 × 19.5536 = 71,438.88 € | |
2. Estimation of AnTC of the appraised before negotiation: | |
To estimate costs of Inlyta 5 mg 56 tabl. Before negotiation all the data were extracted from the German Drug Directory (Lauer) the 15th September 2013, so that no bias due to changed statutory manufacturer rebates occur: | |
PSP: 5596.87 € | |
Mandatory pharmacy rebate: 1.85 € | |
Mandatory manufacturer rebate: 723.12 € | |
Costs after subtraction of statutory mandated rebates: 5596.87 € - 1.85 € - 723.12 € = 4871.90 € | |
AnTC before negotiation = 4871.90 € ×  19.5536 = 95,263.19 € | |
3. AnTC of the ACT (added benefit): | |
Subgroup 1: Everolimus 49,569.47 €; No added benefit | |
Subgroup 2: Sorafenib 55,314.19 €; Indication for a minor added benefit | |
4. Estimation of subgroup proportion: | |
Subgroup 1: 914 patients = 914/920 = 0.99 weighting coefficient SG1 | |
Subgroup 2: 6/920 patients = 0.01 weighting coefficient SG2 | |
5. Calculation of premiums | |
5.1 Additive premium on subgroup-specific ACT: | |
Premium2 = (71,438.88 € - 0.99 × 49,569.47 € - 0.01 × 55,314.19 €)/0.01 = 2,181,196.49 € | |
5.2M ultiplicative premium on subgroup-specific ACT: | |
Premium2 = (71,438.88 € - (0.99 × 49,569.47 €))/(0.01 × 55,314.19 €) = 40,432.85 € | |
5.3 Additive premium on weighted ACT | |
Premium 71,438.88 € - 0.99 × 49,569.47 € - 0.01 × 55,314.19 € = 21,811.96 € | |
5.4 Multiplicative premium on weighted ACT | |
71,438.88 €/(0.99 × 49,569.47 € + 0.01 × 55,314.19 €) = 1.4395 |