Arzneimittelausgaben in Österreich

Die gesamten Arzneimittelausgaben für das Jahr 2015 beliefen sich laut einer Studie der Gesundheit Österreich Forschungs- und Planungs GmbH, die vom Hauptverband der Österreichischen Sozialversicherungsträger in Auftrag gegeben wurde, auf 5,075 Milliarden Euro. Dies entspricht einem Anteil von 13,5 Prozent der Gesamtgesundheitsausgaben (37,5 Mrd. Euro). 4,27 Milliarden (84 Prozent) können dem niedergelassenen Bereich zugerechnet werden, der Rest fiel im intramuralen Sektor an. Mit 66 Prozent der Kosten übernahmen die Krankenversicherungsträger den Löwenanteil der Arznei-mittelausgaben. Knapp ein Viertel der Ausgaben trugen die privaten Haushalte. 7 Prozent finanzierte der Staat (Bund, Land, Gemeinde) und 1,5 Prozent beglichen private Krankenversicherungsträger. Eine Gesamtdarstellung der Ausgaben für Arzneimittel ist von hohem Interesse für die Zahler im österreichischen Gesundheitssystem, weil dadurch die Verteilung der Finanzlast aufgezeigt wird. Die Fragmentierung der Finanzierungsträger in Österreich erschwert die Gesamtsicht

Pharmaceutical pricing policies in European countries

European policy makers have been struggling to fulfil the partially conflicting policy goals of (1) granting equitable and timely access to medicines to their citizens, (2) rewarding innovation to pharmaceutical industry and (3) containing costs in order to ensure long-term financial sustainability of the health care system. From 2007/2008 on, Europe was affected by the global financial crisis that hit the countries in the region to different extents. Several countries had to take strict austerity measures, also in the pharmaceutical. Such measures are intended to address market participants such as pharmaceutical industry, wholesalers and pharmacies. Cost-containment is likely to also target patients and consumers by impacting accessibility and affordability of medicines. Change to Win, a US-based non-profit labor organization, addressed Gesundheit Österreich Forschungs- und Planungsgesellschaft GmbH, a legal subsidiary of Gesundheit Österreich GmbH (GÖG/Austrian Health Institute) for non-profit clients, to submit a report about pharmaceutical pricing in European countries in order to investigate measures taken during the global financial crisis and to provide an outlook on planned and future policy measures. The report is intended to be used by CtW Investment Group, which works with pension funds sponsored by unions affiliated with the Change to Win labor federation. In the results section, we start by providing an outlook on the current pattern and expected trends related to pharmaceutical policies as well as a forecast on pharmaceutical expenditure in the European countries over the next years . This is followed by information about most frequently applied policies related to pharmaceutical wholesale, pharmaceutical pricing in general and the commonly applied pricing policy of external price referencing

Novel policy options for reimbursement, pricing and procurement of AMR health technologies

Antimicrobial resistance (AMR) is a global health threat. A key pillar in the multi-faceted approach to tackle AMR includes the development and commercialisation of novel antibiotics to replace those to which patients are increasingly becoming resistant. Another approach is focused on diagnostics, which, among others, help decide whether or not the prescription of an antibiotic is required, thus reducing antibiotic consumption. Medicines and medical devices, hereinafter referred to as health technologies, usually enter the market of a country after the public authority has decided whether, and to what extent, the cost of the specific health technology will be paid for by the public payer. Linked to these reimbursement and procurement decisions, the price of the health technologies can also be determined by authorities. AMR health technologies have special characteristics such as a dearth of data and evidence, a value to society higher than added therapeutic benefit, and comparably low prices of antibiotics compared to diagnostics. These considerations are not yet well captured by the current standard policies on reimbursement, pricing and procurement. There is a need for a more finely tuned set of specific policy options. Against this backdrop, the study aimed to identify specific policy options in reimbursement, pricing and procurement that are able to incentivise production and market entry of AMR health technologies (novel antibiotics and diagnostics). Included are examples of national policies already in place for AMR health technologies as well as for health technologies with similar characteristics

Avaliação das aquisições centralizadas dos medicamentos em Portugal

O presente estudo avalia as aquisições centralizadas dos medicamentos (ACM) em Portugal numa perspetiva de saúde pública e desenvolve recomendações políticas. A "Metodologia para a avaliação dos sistemas de aquisição" (MAPS, na sigla em inglês) da OCDE foi aplicada de forma adaptada. As informações foram obtidas da literatura e de documentos de aquisições, incluindo propostas de procedimentos de aquisição selecionados, e de 42 entrevistas, das quais 37 realizadas no local com representantes de autoridades públicas, hospitais e administrações regionais de saúde, pacientes e indústria farmacêutica. O input de especialistas em aquisições de 5 países europeus, de participantes portugueses num seminário de pessoas interessadas e de académicos num inquérito Delphi contribuiu para a garantia de qualidade, participação e aceitação. A Serviços Partilhados do Ministério da Saúde (SPMS) é responsável pela realização dos processos de aquisições centralizadas, os quais compreendem procedimentos abertos (Aquisições centralizadas / AC) com um (ou dois) fornecedores e processos de Acordos Quadros / AQ) de duas fases. A aplicação jurídica das ACM está em conformidade com as normas europeias, e concluiu-se que o sistema português tem várias forças. Trata-se nomeadamente da sua contribuição para preços mais baixos (em comparação com aquisições individuais) em vários casos (mas não todos) e, por conseguinte, de poupanças para o sector público, de uma maior transparência dos processos e da governação, de uma maior equidade no acesso aos medicamentos em Portugal, e de um menor volume de trabalho para os adquirentes individuais. Contudo, foram também identificadas as fraquezas. [...

Assessment of centralised procurement of medicines in Portugal

This study assesses the performance of centralised procurement of medicines (CPM) in Portugal from a public health perspective and develops policy recommendations. The OECD “Methodology for Assessing Procurement Systems” (MAPS) was applied in an adapted manner. Information was retrieved from the literature and procurement documents, including bids of selected procurement procedures, and from 42 interviews, thereof 37 on-site interviews with representatives of public authorities, hospitals and regional health administrations, patients and the pharmaceutical industry. Input of procurement experts of five European countries, of Portuguese participants in a stakeholder workshop and of academics in a Delphi survey have contributed to quality-assurance, participation and acceptance. The Shared Services of the Ministry of Health (SPMS) is responsible for performing centralised procurement processes, which comprise both open procedures (Aquisições centralizadas / AC) with one (or two) suppliers and the two-stage processes of framework agreements (Acordos Quadros / AQ). Legal implementation of CPM is compliant with European standards, and the Portuguese system was found to have several strengths. These include its contribution to lower prices (compared to individual purchases) in several (but not all) cases and thus to savings for the public sector, to improved transparency of processes and governance, to more equity in access to medicines across Portugal and to a lower workload for individual procurers. However, weaknesses were also identified. There is a lack of strategy related to CPM and a lack of clarity related to the roles and responsibilities of SPMS and further relevant public institutions and stakeholders with regard to their CPM activities. [...

Assessment of centralised procurement of medicines in Portugal

This study assesses the performance of centralised procurement of medicines (CPM) in Portugal from a public health perspective and develops policy recommendations. The OECD “Methodology for Assessing Procurement Systems” (MAPS) was applied in an adapted manner. Information was retrieved from the literature and procurement documents, including bids of selected procurement procedures, and from 42 interviews, thereof 37 on-site interviews with representatives of public authorities, hospitals and regional health administrations, patients and the pharmaceutical industry. Input of procurement experts of five European countries, of Portuguese participants in a stakeholder workshop and of academics in a Delphi survey have contributed to quality-assurance, participation and acceptance. The Shared Services of the Ministry of Health (SPMS) is responsible for performing centralised procurement processes, which comprise both open procedures (Aquisições centralizadas / AC) with one (or two) suppliers and the two-stage processes of framework agreements (Acordos Quadros / AQ). Legal implementation of CPM is compliant with European standards, and the Portuguese system was found to have several strengths. These include its contribution to lower prices (compared to individual purchases) in several (but not all) cases and thus to savings for the public sector, to improved transparency of processes and governance, to more equity in access to medicines across Portugal and to a lower workload for individual procurers. However, weaknesses were also identified. There is a lack of strategy related to CPM and a lack of clarity related to the roles and responsibilities of SPMS and further relevant public institutions and stakeholders with regard to their CPM activities. [...

Meteorological factors and non-pharmaceutical interventions explain local differences in the spread of SARS-CoV-2 in Austria

The drivers behind regional differences of SARS-CoV-2 spread on finer spatio-temporal scales are yet to be fully understood. Here we develop a data-driven modelling approach based on an age-structured compartmental model that compares 116 Austrian regions to a suitably chosen control set of regions to explain variations in local transmission rates through a combination of meteorological factors, non-pharmaceutical interventions and mobility. We find that more than 60% of the observed regional variations can be explained by these factors. Decreasing temperature and humidity, increasing cloudiness, precipitation and the absence of mitigation measures for public events are the strongest drivers for increased virus transmission, leading in combination to a doubling of the transmission rates compared to regions with more favourable weather. We conjecture that regions with little mitigation measures for large events that experience shifts toward unfavourable weather conditions are particularly predisposed as nucleation points for the next seasonal SARS-CoV-2 waves

Study on Cross-Border Cooperation: Capitalising on existing initiatives for cooperation in cross-border regions Final report

The study investigates past achievements and potential future developments in the field of cross-border healthcare collaboration. The findings are based on a mapping of EUfunded cross-border healthcare initiatives, foresight modelling for cross-border healthcare in 2030, a systematic literature review on fraud and fraud mitigation in crossborder healthcare and an evaluation of take-up of the Joint Action on Patient Safety and Quality of Care (PaSQ). The study also provides practical tools to assist stakeholders, including local and regional authorities, who intend to start a cross-border healthcare collaboration project. The study enhances an in-depth understanding of cross-border healthcare collaborations and provides new knowledge to the field on different aspects of cross-border healthcare research. Seven lessons are summarised in the following: 1. Cross-border healthcare initiatives are more effective in regions where ease of cooperation is already established, e.g. due to similar welfare traditions or close historical ties. 2. Support should be given to key players such as regional policy-makers or hospital managers to reduce transaction costs of cross-border healthcare. The toolbox developed in this study can provide help1. 3. There are several scenarios for future cross-border healthcare, one of the most realistic ones being one which builds regional networks oriented towards addressing local and regional needs. 4. Regional networks are likely to represent a low-cost option, but the downsides are that they are likely to remain small-scale and they may create inequities by not benefiting all regions equally. 5. Top categories of cross-border healthcare initiatives to receive EU-funding over the past 10 years are 1) knowledge sharing and management, and 2) shared treatment & diagnosis of patients. 6. Collaborations such as high-cost capital investments and emergency care tend to have more discernible economic and social benefits, but require more formalised terms of cooperation. 7. Although information on the effectiveness and sustainability of current cross-border healthcare initiatives is scarce, funding of CBHC projects could help achieve these aim