Authors' objectives: The National Institute for Health and Disability Insurance (NIHDI) has asked the KCE to develop recommendations: 1. for making projections of the national pharmaceutical expenditures by using horizon scanning; 2. for structural implementation of budget impact projection, notably for drugs with potentially large impact on the healthcare system. The aim of this project is to develop recommendations for systematic projections of total pharmaceutical expenditures in Belgium from the healthcare payer perspective. The scope of the recommendations includes methods and organisational needs to perform the projections for the pharmaceutical products already on the market and those products anticipated to receive marketing authorisation and/or reimbursement during the projection period.

Authors' methods: The project consisted of four phases: 1. Explorative phase: analysis of current practices for national pharmaceutical expenditure projections through a systematic literature review and consultations with (inter)national experts. 2. Conceptual phase: developing recommendations for national pharmaceutical expenditure projections based on the best practices captured in the explorative phase. 3. Pilot phase: testing the proposed recommendations in a proof-of-concept study. 4. Reflection phase: discussion of lessons learnt and practical recommendations.

Authors' identified further research: • Some important questions related to a national implementation of budget impact projections were out of the scope of this project, or could not be implemented due to a delay in data delivery and therefore remained unanswered. For example: • What is the predictive accuracy of PROMES model if compared with the crude prediction model developed within this project? • What would be the best method for integration of horizon scanning forecasts in the data-driven models? How will such integration affect the transparency and accuracy of the predictive models? • How can pharmaceutical expenditure projections be practically used to improve the NIHDI short-term budgeting? • How can other elements not considered until now, be factored in the expenditure projections, e.g. national health objectives, transversal budget impact (think about possible savings outside the pharmaceutical budget due to curative effect of some very expensive treatments), specific policy programs etc.? An initial interaction between NIHDI, PROMES, KCE and pharmaceutical industry associations revealed a need for more profound exchange on different projection methods. To develop a coherent fit-for purpose approach to pharmaceutical expenditure projections, a clear vision on the purpose and policy application of forecasts with different time horizons is warranted. Regardless the applied approach, the methodologies and assumptions used for the pharmaceutical expenditure projections should always be carefully document. The accuracy of predictions should be annually assessed by comparing them with the actual expenditures. Analysing the reasons of the forecasting errors should improve the next iteration of predictions.

Project Status: Completed

Year Published: 2024

URL for published report: https://doi.org/10.57598/R381C

URL for additional information: https://kce.fgov.be/en/publications/all-reports/budget-impact-projections-for-pharmaceuticals

English language abstract: An English language summary is available

Publication Type: Other

Country: Belgium

DOI: 10.57598/R381C

Organisation Name: Belgian Health Care Knowledge Centre

Contact Address: Administrative Centre Botanique, Doorbuilding (10th floor), Boulevard du Jardin Botanique 55, B-1000 Brussels, Belgium tel: +32 2 287 33 88 fax: +32 2 287 33 85

Contact Name: info@kce.fgov.be

Contact Email: info@kce.fgov.be

Copyright: <p>Belgian Health Care Knowledge Centre (KCE)</p>