How innovative are pharmaceutical innovations?: the case of medicines financed through add-on payments outside of the French DRG-based hospital payment system

Objective: To analyze the characteristics of inpatient medicines placed on the list of innovative high-cost medicines funded in addition to DRG-based payment, and to identify whether they really are innovative and/or high-cost.

Methodology: The medicines placed on the list of innovative and high-cost medicines were analyzed on the basis of criteria describing their innovative nature and cost. They were categorized as innovative and high-cost, only high-cost, only innovative and neither innovative nor high-cost.

Results: Among the medicines financed in addition to DRG-based payment, 25.5% were classified as innovative and high-cost, 23.5% only high-cost, 22.9% only innovative and 28.1% neither innovative nor high-cost.

Conclusions: The list of innovative and high-cost medicines contains medicines other than innovative and high-cost medicines. Stricter criteria for placing medicines on this list should be considered in order to limit the increase in expenditure.