The pharmaceutical distribution chain in the European Union: structure and impact on pharmaceutical prices

In an environment characterised by fragmentation in the market structure of wholesale and retail entities, significant diversity in terms of remuneration schemes as well as regulations pertaining to operational features of wholesale and retail entities, but also significant developments in policy and practice concerning distribution, the objective of this report, is twofold: First, to map the distribution chain in EU Member States, including the main actors in wholesaling and retailing, discuss the requirements to provide certain services and outline their sources of remuneration, both direct and indirect. Second, to collect and analyse data on distribution margins, fees and service requirements in the originator and generic markets in EU Member States with a view to understanding the impact the distribution chain is having on the prices of reimbursable prescription only medicines (POMs). The report does not address issues relating to over-the-counter (OTC) medications

The dynamics of colorectal cancer management in 17 countries

This paper discusses the current care management arrangements for colorectal cancer (CRC) in 16 OECD countries plus the Russian Federation by analysing data sources, the uptake of screening and surveillance, the available capacity in endoscopy services, the treatment pathways in medical treatment, as well as the type and availability of pharmaceutical care. The paper highlights significant variations in practice across the 17 countries. Common themes emerge from each of these practices and standards in terms of political interest in policies and awareness of CRC (both of which need to be enhanced), affordability (in terms of scarcity of resources in some countries and out-of-pocket payments for parts of the overall treatment process), access (in terms of the significant variation that has been observed within and across countries with regard to diagnostics, treatment and certain pharmaceuticals) and quality of CRC services (which may arise due to variations in treatment and pharmaceutical guidelines as well as minimal monitoring). When considering policy options for the future, it is important to, first, improve data collection both within as well as across countries through international co-operation; second, it is critical to have greater national and international support for cancer screening activities proven to be effective and cost-effective; third, endoscopy capacity in individual countries needs to be improved, also allowing more choice to ensure timely diagnosis, regardless of screening activities; fourth, public and political awareness needs to be enhanced as it is the key to improving CRC outcomes; fifth, where appropriate, to give consideration to the principles of equity, human dignity and disease severity, among others, when deciding on the uptake of new (targeted) treatments, rather than base decisions solely on cost-effectiveness criteria; and sixth, to firm up national guidelines including screening, diagnosis, treatment, pharmaceutical treatments and surveillance, with a view to enhancing their timeliness, evidence-base and free access to all

The dynamics of colorectal cancer management in 17 countries

Colorectal cancer, Access, Availability, Affordability, Health technology assessment, Screening, Practice guidelines, Quality of care, Cancer management, Health policy, I11, I12, I18,

The status of colorectal cancer care in the Netherlands: past, present and future

Colorectal cancer, The Netherlands, Screening, Treatment access, Expenditure, I11, I12, I18,

Cancer management and reimbursement aspects in Germany: an overview demonstrated by the case of colorectal cancer

Colorectal cancer, Cancer management, Germany, CRC, Health policy, I11, I12, I18,

The burden of colorectal cancer: prevention, treatment and quality of services

I11, I12, I18,

Colorectal cancer management in the United Kingdom: current practice and challenges

This paper explores the current situation of colorectal cancer (CRC) management in the UK. Colorectal cancer is the third leading cause of cancer death in the UK, and the second and third leading cause of new cancer cases in women and men, respectively. These figures have increased over the past decade and, coupled with poorer survival rates compared to the European average and an ageing population, have recently led to the implementation of national screening in 2007–2009. Staffing adjustments are being made in preparation for national CRC-related demands, and national treatment guidelines are currently being revised. Access to new targeted treatments, however, is very limited due to negative NICE guidance and access is granted to only a select few. Targets have been created with regards to time to diagnosis and treatment, which are generally being met by the majority of hospitals. Overall, the focus on screening activities in the UK will hopefully result in fewer end-stage CRC cases and associated costlier treatments