Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October System of counting reimbursement costs by public payers PPRI Project Christine Leopold Gesundheit Österreich GmbH PPRI Conference Warsaw, 29 October 2007

Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October  European averages  EU-25:18.6%  EU-15:15.6 %  EU-10:23.7%  Member States differences  <= 10%: LU, DK, IE, NL; NO  => 25%: BG, HU, LT, PL, SI, SK Pharmaceutical Expenditure in % of Health Expenditure (2005)

Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October Public/private funding of pharmaceutical expenditure Source: PPRI 2007

Pharmaceutical Pricing & Reimbursement Information ÖBIG 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 ÖBIG 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 ÖBIG 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 ÖBIG Warsaw 29 October Share of private pharmaceutical expenditure Burden for the patients * HU: 2000=2001, 2005 = 2004 Source: OECD Health Data 2007