1. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20071 System of counting reimbursement costs by public payers PPRI Project Christine Leopold Gesundheit Österreich GmbH PPRI Conference Warsaw, 29 October 2007

2. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20072  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)

3. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20073 Public/private funding of pharmaceutical expenditure Source: PPRI 2007

4. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20074  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?

5. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20075  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

6. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20076  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

7. Pharmaceutical Pricing & Reimbursement Information ÖBIG Warsaw 29 October 20077 Share of private pharmaceutical expenditure Burden for the patients * HU: 2000=2001, 2005 = 2004 Source: OECD Health Data 2007