Cost-Effectiveness Analysis of Spending on Research and Development to Address the Needs for Innovative Therapeutic Products in Indonesia

Figures & data

Figure 1 Decision tree model.

Table 1 Parameters Used in the Model

Parameter	Value	Reference
Success rate
Stage 1	33%	^Citation18
Stage 2	50%	^Citation18
Stage 3	75%	^Citation18
Stage 4	83%	^Citation18
Low commercial value	25%	^Citation18
Base commercial value	50%	^Citation18
High commercial value (innovative product)	25%	^Citation18
R&D budget
Gross domestic expenditure on R&D (GERD in US$ million)	$6307.26	^Citation2
% of GERD for medical and health sciences	18.72%	^Citation19
GERD (in US$ million) for medical and health sciences (baseline)	$1180.45	Calculation
GERD (in US$ million) for medical and health sciences (scenario 1)	2x baseline	Assumption
GERD (in US$ million) for medical and health sciences (scenario 2)	3x baseline	Assumption
GERD (in US$ million) for medical and health sciences per researcher	$0.14
Shared budget of stage 1	21.50%	^Citation35
Shared budget of stage 2	32.50%	^Citation35
Shared budget of stage 3	32.50%	^Citation35
Shared budget of stage 4	13.50%	^Citation35
Innovative products
% of innovative products in health and medical sciences (baseline)	16.97%	Calculation
% of innovative products in health and medical sciences (scenario 1)	20.83%	Calculation
% of innovative products in health and medical sciences (scenario 2)	28.36%	Calculation

Table 2 R&D Performance of All Included Countries²

No.	Country	Country Classification by Income Level	Government Expenditure on R&D (GERD, Million)	GERD per Capita	GERD per Researcher (Million)	GERD in Medical and Health Sciences (Million)	Innovative Products in Medical and Health Sciences
1	Bulgaria	Middle-income	$1068.38	$149	$0.07	$297.96	12.50%
2	Croatia	High-income	$869.02	$206	$0.12	$182.11	14.29%
3	Denmark	High-income	$8756.07	$1536	$0.20	$2924.93	20.83%
4	Ecuador	Middle-income	$734.52	$46	$0.12	$31.84	16.22%
5	Estonia	High-income	$578.95	$439	$0.13	$55.32	16.67%
6	Hungary	High-income	$3656.33	$374	$13	$226.23	17.07%
7	Kazakhstan	Middle-income	$674.41	$38	$0.05	$28.20	6.38%
8	Latvia	High-income	$298.33	$150	$0.08	$24.83	10.00%
9	Malta	High-income	$109.23	$252	$0.13	$21.08	14.29%
10	Netherlands	High-income	$17,710.53	$1044	$0.21	$2831.43	28.36%
11	Poland	High-income	$10,651.89	$280	$0.16	$1076.54	18.38%
12	South Korea	High-income	$81,556.19	$1603	$0.22	$5537.41	33.24%
13	Romania	High-income	$2142.29	$108	$0.12	$179.00	9.86%
14	Serbia	Middle-income	$897.37	$127	$0.06	$56.55	9.98%
15	Ukraine	Middle-income	$2123,0.4	$49	$0.05	$84.42	9.00%
16	Uruguay	High-income	$281.47	$82	$0.12	$43.38	12.99%

Figure 2 Linear regression analysis on countries’ GERD for medical and health sciences with the percentage of innovative products.

Table 3 Incremental Cost-Effectiveness Ratio (ICER) in a 3-Year Time Horizon Analysis

Intervention	Value
Baseline
GERD for medical and health sciences (US$ million)	$3541.34
Number of R&D ideas	24,601
Stage 1 (22.40%)	5511
Stage 2 (33.94%)	1871
Stage 3 (50.92%)	953
Stage 4 (56.35%)	537
Number of innovative products (16.97%)	91
Scenario 1
GERD for medical and health sciences (US$ million)	$7082.67
Number of R&D ideas	49,203
Stage 1 (27.50%)	13,531
Stage 2 (41.67%)	5638
Stage 3 (62.50%)	3524
Stage 4 (69.17%)	2437
Number of innovative products (20.83%)	508
ICER (cost in US$ million per innovative product)	$8.50
Scenario 2
GERD for medical and health sciences (US$ million)	$10,624.01
Number of R&D ideas	73,804
Stage 1 (37.43%)	27,627
Stage 2 (56.72%)	15,669
Stage 3 (85.07%)	13,330
Stage 4 (94.15%)	12,550
Number of innovative products (28.36%)	3559
ICER (cost in US$ million per innovative product)	$2.04

Table 4 Cost per Innovative Product on the Sensitivity Analysis

Parameter	ICER (US$ million)
	Scenario 1	Scenario 2
Baseline	$8.50	$2.04
Success rate of stage 1 (+20%)	$7.01	$1.68
Success rate of stage 1 (−20%)	$10.79	$2.59
Success rate of stage 2 (+20%)	$7.08	$1.70
Success rate of stage 2 (−20%)	$10.62	$2.55
Success rate of stage 3 (+20%)	$7.08	$1.70
Success rate of stage 3 (−20%)	$10.62	$2.55
Success rate of stage 4 (+20%)	$7.05	$1.70
Success rate of stage 4 (−20%)	$10.69	$2.57
GERD for medical and health sciences (+20%)	$10.20	$2.45
GERD for medical and health sciences (−20%)	$6.80	$1.63
Shared budget of stage 1 (+20%)	$8.88	$2.13
Shared budget of stage 1 (−20%)	$8.12	$1.95
Shared budget of stage 2 (+20%)	$9.05	$2.18
Shared budget of stage 2 (−20%)	$7.95	$1.91
Shared budget of stage 3 (+20%)	$9.05	$2.18
Shared budget of stage 3 (−20%)	$7.95	$1.91
Shared budget of stage 4 (+20%)	$8.71	$2.09
Shared budget of stage 4 (−20%)	$8.29	$1.99

Boer FP. The Valuation of Technology: Business and Financial Issues in R&D, Operations Management Series for Professionals. New York: John Wiley; 1999.

 Google Scholar

UNESCO Institute for Statistics. Science, Technology and Innovation. Available from: http://data.uis.unesco.org/#. Accessed June 10, 2020.

 Google Scholar

CNN Indonesia. Indonesia Research Budget; 2020. Available from: https://www.cnnindonesia.com/teknologi/20200128122325-199-469363/anggaran-riset-dan-pengabdian-masyarakat-2020-capai-rp146-t. Accessed April 10, 2020.

 Google Scholar

International Federation of Pharmaceutical Manufacturers & Associations. The pharmaceutical industry and global health, facts and figures 2017. Available from: https://www.ifpma.org/wp-content/uploads/2017/02/IFPMA-Facts-And-Figures-2017.pdf. Accessed April 5, 2020.

 Google Scholar