Document Server@UHasselt >
Research >
Research publications >

Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/14415

Title: Similarities and differences between five european drug reimbursement systems
Authors: Franken, Margreet
le Polain, Maite
Koopmanschap, Marc
Issue Date: 2012
Abstract: Objectives: The aim of our study is to compare five European drug reimbursement systems, describe similarities and differences, and obtain insight into their strengths and weaknesses and formulate policy recommendations. Methods: We used the analytical Hutton Framework to assess in detail drug reimbursement systems in Austria, Belgium, France, the Netherlands, and Sweden. We investigated policy documents, explored literature, and conducted fifty-seven interviews with relevant stakeholders. Results: All systems aim to balance three main objectives: system sustainability, equity and quality of care. System impact, however, is mainly assessed by drug expenditure. A national reimbursement agency evaluates reimbursement requests on a case-by-case basis. The minister has discretionary power to alter the reimbursement advice in Belgium, France, and the Netherlands. All systems make efforts to increase transparency in the decision-making process but none uses formal hierarchical reimbursement criteria nor applies a cost-effectiveness threshold value. Policies to deal with uncertainty vary: financial risk-sharing by price/volume contracts (France, Belgium) versus coverage with evidence development (Sweden, the Netherlands). Although case-by-case revisions are embedded in some systems for specific groups of drugs, systematic (group) revisions are limited. Conclusions: As shared strengths, all systems have clear objectives reflected in reimbursement criteria and all are prepared to pay for drugs with sufficient added value. However, all systems could improve the transparency of the decision-making process; especially appraisal lacks transparency. Systems could increase the use of (systematic) revisions and could make better use of HTA (among others cost-effectiveness) to obtain value for money and ensure system sustainability.
Notes: [Franken, Margreet; Koopmanschap, Marc] Erasmus Univ, Inst Hlth Policy & Management, NL-3000 DR Rotterdam, Netherlands. [le Polain, Maite; Cleemput, Irina] Belgian Hlth Care Knowledge Ctr, Brussels, Belgium. [Cleemput, Irina] Hasselt Univ, Belgian Hlth Care Knowledge Ctr, Diepenbeek, Belgium. franken@bmg.eur.nl
URI: http://hdl.handle.net/1942/14415
DOI: 10.1017/S0266462312000530
ISI #: 000309929200002
ISSN: 0266-4623
Category: A1
Type: Journal Contribution
Validation: ecoom, 2013
Appears in Collections: Research publications

Files in This Item:

There are no files associated with this item.

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.