Can price transparency contribute to more affordable patient access to medicines?

No abstract available

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

How large are the differences between originator and generic prices? Analysis of five molecules in 16 European countries

OBJECTIVE: To survey the price differences between originators and generics for a selected basket of molecules and to analyze similarities and differences with regard to the countries included and their generic policies. METHODS: Ex-factory prices as of November 2011 of five molecules provided from the Pharma Price Information (PPI) service of the Austrian Health Institute were analyzed for 16 European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, the Netherlands, Norway, Portugal, Spain, Switzerland, Sweden, UK). The selected molecules were gemcitabine, mycophenolate mofetil, olanzapine, risperidone and sumatriptan. For a specific presentation (same pack size, dosage and pharmaceutical form) of each molecule, the prices of the original product and the “most common generic” as defined by PPI were compared. RESULTS: Considerable variations among the extent of price differences between originator and generic were identified (gemicitabine: lowest price difference of 1.4% between originator and generic in Belgium and highest difference of 73.4% in Portugal; mycophenolate mofetil: 3.4% Norway – 71.7% Netherlands; olanzapine: 0.1% Spain – 97.1% Sweden; risperidone: 0.9% Netherlands – 97.3% UK; sumatriptan: 5.8% Greece – 95.0% Denmark). Further, no difference at all between originator and generic prices was found for some molecules in a few countries (Norway: for 4 of the 5 molecules analyzed; Spain: 3; Belgium: 2; in Austria, France and Greece for one molecule respectively). For the five molecules of the sample, Greece, Spain, Ireland and Norway consistently displayed lower price differences whereas Denmark, Finland and Sweden tended to show higher differences between originator and generic prices. CONCLUSION: Even if this research is illustrative and not representative due to the small sample size, results suggest confirming large differences across Europe. It appears that countries (e.g. Denmark, Sweden) with strong generic policies, particularly based on competition and involving elements of enforcement, tend to have higher differences between originator and generic prices. Further research, notably with a broader basket, is recommended

Socioeconomic determinants of medicines use in Central Eastern Europe: the role of pharmaceutical policy in reducing inequalities

(no abstract available

Comparing pharmaceutical pricing and reimbursement policies in Croatia to the European Union Member States

Aim To perform a comparative analysis of the pharmaceutical pricing and reimbursement systems in Croatia and the 27 European Union (EU) Member States. Methods Knowledge about the pharmaceutical systems in Croatia and the 27 EU Member States was acquired by literature review and primary research with stakeholders. Results Pharmaceutical prices are controlled at all levels in Croatia, which is also the case in 21 EU Member States. Like many EU countries, Croatia also applies external price referencing, ie, compares prices with other countries. While the wholesale remuneration by a statutorily regulated linear mark-up is applied in Croatia and in several EU countries, the pharmacy compensation for dispensing reimbursable medicines in the form of a flat rate service fee in Croatia is rare among EU countries, which usually apply a linear or regressive pharmacy mark-up scheme. Like in most EU countries, the Croatian Social Insurance reimburses specific medicines at 100%, whereas patients are charged copayments for other reimbursable medicines. Criteria for reimbursement include the medicine’s importance from the public health perspective, its therapeutic value, and relative effectiveness. In Croatia and in many EU Member States, reimbursement is based on a reference price system. Conclusion The Croatian pharmaceutical system is similar to those in the EU Member States. Key policies, like external price referencing and reference price systems, which have increasingly been introduced in EU countries are also applied in Croatia and serve the same purpose: to ensure access to medicines while containing public pharmaceutical expenditur

Spatial Education for Different User Groups as a Prerequisite for Creating a Spatially Enabled Society and Leveraging SDI

During recent years spatial data infrastructure (SDI) concepts have developed towards user-centered initiatives, whose creation is strongly driven by user requirements. Closely related to (user-centric) SDIs is the vision of spatially enabled societies where access to and use of spatial data is regarded as relevant support for everyone to organize their activities. Both user-centric SDI models and the concept of spatially enabled societies focus on large and diverse user communities encompassing, besides public and private sector organizations, the general public as well. Although the benefits of spatial data use for professional reasons are widely recognized, awareness of the potential advantages for private life such as activities related to citizenship (civic duties and rights) has only recently been raised. Nevertheless, most citizens, as non-professionals regarding spatial data use, face difficulties when carrying out tasks related to the use of resources provided by a SDI. While capacity building is a long-established feature to ensure effective use by professionals, the need for citizens’ spatial education has lately become an important consideration. This asks, on the one hand, for the specification of skills and competencies required on the part of citizens to open up opportunities to benefit from SDIs and on the other hand, suitable education initiatives addressing the general public. Therefore, this paper argues that “Spatial Citizenship” seems to be an appropriate education approach to train user groups as pupils/ students and adults (non-GI professionals), who demand for different education initiatives adjusted to their particular situation

Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession: interrupted time series analyses

Objectives: To analyze the impacts of pharmaceutical sector policies implemented to contain country spending during the economic recession – a reference price system in Finland and a mix of policies including changes in reimbursement rates, a generic promotion campaign and discounts granted to the public payer in Portugal – on utilization of, as a proxy for access to, antipsychotic medicines. Methodology We obtained monthly IMS Health sales data in standard units of antipsychotic medicines in Portugal and Finland for the period January 2007 to December 2011. We used an interrupted time series design to estimate changes in overall use and generic market shares by comparing pre-policy and post-policy levels and trends. Results: Both countries’ policy approaches were associated with slight, likely unintended, decreases in overall use of antipsychotic medicines and with increases in generic market shares of major antipsychotic products. In Finland, quetiapine and risperidone generic market shares increased substantially (estimates one year post-policy compared to before, quetiapine: 6.80% [3.92%, 9.68%]; risperidone: 11.13% [6.79%, 15.48%]. The policy interventions in Portugal resulted in a substantially increased generic market share for amisulpride (estimate one year post-policy compared to before: 22.95% [21.01%, 24.90%]; generic risperidone already dominated the market prior to the policy interventions. Conclusions: Different policy approaches to contain pharmaceutical expenditures in times of the economic recession in Finland and Portugal had intended – increased use of generics – and likely unintended – slightly decreased overall sales, possibly consistent with decreased access to needed medicines – impacts. These findings highlight the importance of monitoring and evaluating the effects of pharmaceutical policy interventions on use of medicines and health outcomes

Die Einführung der Reformation und ihre kulturhistorischen Folgen für Niedersachsen

Background information on pharmaceutical policies in 8 Central and Eastern European countries; description of data: Country background information giving an overview of pharmaceutical policies as well as key challenges by country. Sources: All: [49]; Bulgaria: [7, 10, 58, 83, 101, 118]; Czech Republic: [7, 9, 10, 82, 100, 109, 110, 113, 120, 121]; Hungary: [10, 12, 16, 21, 64, 85, 91, 104, 106, 119, 121]; Latvia: [60, 86, 88, 102, 107, 114, 122]; Poland: [8, 95, 96, 103, 111, 115, 123, 124]; Romania: [9, 10, 63, 71, 84, 89, 92, 94, 97, 98, 125]; Slovenia: [7, 9, 10, 70, 81, 126, 127]; Slovakia: [85, 100, 105, 108, 116, 128,129]. (DOCX 30 kb