Impediments to the diffusion of innovative medicines in Europe.

The pharmaceutical industry has developed many innovative medicines, which are able to extend the life expectancy of patients to increase their quality of life and often to reduce expenditures in the health care sector as a whole. Although these medicines are available in principle for all eligible patients throughout Europe, not everyone receives adequate treatment. There is a huge difference between a possible optimal treatment and the treatment delivered to the patient. In some cases patients are not treated at all; in some cases they only receive outdated medicines (e.g. with lower effectiveness and/or more severe side effects); and in some cases the prescribed dosages of the innovative drugs are too low to be effective. This study gives an overview of the shortfalls in provision of state-of-the-art medicines in selected European countries for about 20 of the most relevant diseases. The following five different groups of factors can be identified as leading to this insufficient diffusion of medicines and are discussed in this text: (i) patient-related factors; (ii) healthcare professional-related factors; (iii) industry-related factors; (iv) system-related (long-term) factors; and (v) policy-related (short-term) factors. It must be clear that these shortages are not isolated cases but general trends in Europe, which have to be discussed in public.