https://orcid.org/0000-0001-8671-2065
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Abstract
Background
The annual gross domestic expenditure on research and development (GERD) per capita of Indonesia ($24) remains relatively lower than the annual GERD per capita of neighboring countries, such as Vietnam ($36), Singapore ($1804), Malaysia ($361), and Thailand ($111).
Objective
The aim of this study was to conduct a cost-effectiveness analysis of spending on healthcare R&D to address the needs of developing innovative therapeutic products in Indonesia.
Methods
A decision tree model was developed by taking into account four stages of R&D: stage 1 from raw concept to feasibility, stage 2 from feasibility to development, stage 3 from development to early commercialization, and stage 4 from early to full commercialization. Considering a 3-year time horizon, a stage-dependent success rate was applied and analyses were conducted from a business perspective. Two scenarios were compared by assuming the government of Indonesia would increase GERD in health and medical sciences up to 2- and 3-times higher than the baseline (current situation) for the first and second scenario, respectively. Cost per number of innovative products in health and medical sciences was considered as the incremental cost-effectiveness ratio (ICER). Univariate sensitivity analysis was conducted to investigate the effects of different input parameters on the ICER.
Results
There was a statistically significant association (P-value<0.05) between countries’ GERD in medical and health sciences with the number of innovative products. We estimated the ICER would be $8.50 million and $2.04 million per innovative product for the first and second scenario, respectively. The sensitivity analysis showed that the success rates in all stages and total GERD were the most influential parameters impacting the ICER.
Conclusion
The result showed that there was an association between GERD in medical and health sciences with the number of innovative products. In addition, the second scenario would be more cost-effective than the first scenario.
Acknowledgment
This research was partially funded by the Indonesian Ministry of Research and Technology/National Agency for Research and Innovation, and Indonesian Ministry of Education and Culture, under the World Class University Program managed by Institut Teknologi Bandung for Rizky Abdulah.
Disclosure
Professor Maarten Jacobus Postma reports Health-Ecore and PAG BV stocks, grants, and personal fees from Astra Zeneca, GSK, Boehringer Ingelheim, Janssen, MSD, Sanofi, and Sequiris, grants from BMS, WHO, and BioMerieux, and personal fees from Merck, Alexion, Asc Academics, Parexel, Pfizer, IQVIA, Novo Nordisk, and Sanofi, outside the submitted work. The authors report no other potential conflicts of interest for this work.