Vogler Sabine, Zimmermann Nina, de Joncheere Kees
WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich GmbH (Austrian Public Health Institute), Vienna, Austria.
WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Pharmacoeconomics Department, Gesundheit Österreich GmbH (Austrian Public Health Institute), Vienna, Austria.
Health Policy. 2016 Dec;120(12):1363-1377. doi: 10.1016/j.healthpol.2016.09.006. Epub 2016 Sep 20.
Policy-makers can use a menu of pharmaceutical policy options. This study aimed to survey these measures that were implemented in European countries between 2010 and 2015.
We did bi-annual surveys with competent authorities of the Pharmaceutical Pricing and Reimbursement Information network. Additionally, we consulted posters produced by members of this network as well as further published literature. Information on 32 European countries (all European Union Member States excluding Luxembourg; Iceland, Norway, Serbia, Switzerland, Turkey) was included.
557 measures were reported between January 2010 and December 2015. The most frequently mentioned measure was price reductions and price freezes, followed by changes in patient co-payments, modifications related to the reimbursement lists and changes in distribution remuneration. Most policy measures were identified in Portugal, Greece, Belgium, France, the Czech Republic, Iceland, Spain and Germany. 22% of the measures surveyed could be classified as austerity.
Countries that were strongly hit by the financial crisis implemented most policy changes, usually aiming to generate savings and briefly after the emergence of the crisis. Improvements in the economic situation tended to lead to an easing of austerity measures. Countries also implemented policies that aimed to enhance enforcement of existing measures and increase efficiency.
政策制定者可以采用一系列药品政策选项。本研究旨在调查2010年至2015年期间在欧洲国家实施的这些措施。
我们每半年对药品定价和报销信息网络的主管当局进行一次调查。此外,我们查阅了该网络成员制作的海报以及其他已发表的文献。纳入了32个欧洲国家(所有欧盟成员国,不包括卢森堡;冰岛、挪威、塞尔维亚、瑞士、土耳其)的信息。
2010年1月至2015年12月期间共报告了557项措施。最常提及的措施是降价和价格冻结,其次是患者自付费用的变化、与报销清单相关的修改以及配送报酬的变化。大多数政策措施在葡萄牙、希腊、比利时、法国、捷克共和国、冰岛、西班牙和德国被确定。所调查的措施中有22%可归类为紧缩措施。
受金融危机冲击严重的国家实施的政策变化最多,通常旨在在危机出现后短期内节省开支。经济形势的改善往往会导致紧缩措施的放松。各国还实施了旨在加强现有措施执行力度和提高效率的政策。