Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October System of counting reimbursement costs by public payers PPRI Project Christine Leopold Gesundheit sterreich GmbH PPRI Conference Warsaw, 29 October 2007 Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October European averages EU-25:18.6% EU-15:15.6 % EU-10:23.7% Member States differences 25%: BG, HU, LT, PL, SI, SK Pharmaceutical Expenditure in % of Health Expenditure (2005) Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October Public/private funding of pharmaceutical expenditure Source: PPRI 2007 Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October On the price level Discounts/rebates Margin cuts Price freezes/price cuts Price reviews On the reimbursement level Reference price system Generic substitution Claw-back / Pay-back Cost-containment mechanism On the level of doctors Pharmaceutical budgets Prescription monitoring Generic prescribing Do these mechanism increase the burden for the patient? Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October Methodology Cluster of equivalent/similar pharmaceuticals Setting a reference price Co-payment for pharmaceuticals with higher price Relevance in all EU Member States but AT, CY, FI, IE, LU, MT, SE, UK System of obligatory substitution in SE Step-price system for off-patent pharmaceuticals in NO Example: Reference price systems Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October Private pharmaceutical expenses Co-payments Prescription fees (e.g. AT, DK, EE, FI, IT, PL, SK, UK) Deductibles (IE) Percentage co-payments Reference price system Burden for the patients Pharmaceutical Pricing & Reimbursement Information BIG Warsaw 29 October Share of private pharmaceutical expenditure Burden for the patients * HU: 2000=2001, 2005 = 2004 Source: OECD Health Data 2007