Potential Initiatives for Containing the Costs of Medicines

• Reference Pricing: one 'reference drug' is chosen from a group of drugs that are equally effective and safe. The price for the reference drug is covered, but if people want a more expensive drug from that group they have to pay the difference in price.
• International Price Comparison: comparisons that make procurement of medicines of assured quality for the lowest possible price possible (International Drug Price Indicator Guide).
• Therapeutic Substitution: a pharmacist-initiated act by which a pharmaceutical or therapeutic alternate for the physician-prescribed drug is dispensed without consulting the physician.
• Paybacks: a way of measuring health services research and its societal benefits (or payback)
• Price-Volume Agreements: public authorities and a manufacturer will work together to try and predict the volume of drug sales. If the actual volume of sales exceeds the prediction, prices are usually lowered.
• Rebates: money given back after the purchase of certain drugs, usually either a percentage of total cost for purchasers who meet certain requirements.
• Usage Restrictions: certain drugs are not covered by programs, due to lack of research, proof of effectiveness.
• Risk-Sharing Agreements: a pharmaceutical company may agree to share the risk on new drugs when there's uncertainty on whether it's effective or worth the cost. They may do this by helping to pay for a drug while it's still new in the marketplace.