NIHR SERVICE DELIVERY AND ORGANISATION PROGRAMME

By CHARLES JACKSON

A COMPARISON OF PHARMACEUTICAL CONSUMPTION IN PER CAPITA VALUES (IN US DOLLARS AND ADJUSTED FOR PURCHASING POWER PARITIES) IS ALSO REVEALING TABLE 1 PHARMACEUTICAL EXPENDITURE AS A PERCENTAGE OF TOTAL HEALTH EXPENDITURE NOTE: FROM EU15 COUNTRIES, AUSTRIA AND IRELAND NOT REPORTED DUE TO LACK OF DATA SOURCE: OECD HEALTH DATA JUNE 2009 NIHR SERVICE DELIVERY AND ORGANISATION PROGRAMME GROUP), SUCH AS SPAIN AND PORTUGAL MANY POLICY MEASURES HAVE BEEN ADOPTED OVER THE YEARS IN EUROPEAN COUNTRIES EVEN THOUGH THESE MEASURES HAVE NOT PREVENTED GROWING PHARMACEUTICAL EXPENDITURES (BOTH IN RELATIVE AND ABSOLUTE TERMS), DISTINCT POLICIES MAY HAVE GENERATED CROSS-COUNTRY DIFFERENCES THE INTERNATIONAL COMPARISON OF PHARMACEUTICAL SPENDING HAS SEVERAL ISSUES TO CONSIDER: NOT ALL DRUGS ARE SOLD IN EVERY COUNTRY AND CONSUMER TABLE 2 PHARMACEUTICAL EXPENDITURE AS A PERCENTAGE OF GDP PRICES USUALLY INCLUDE TAXES AS WELL AS RETAILERS’ AND WHOLESALERS’ MARGINS THESE CAN VARY CONSIDERABLY ACROSS COUNTRIES DESPITE THESE DIFFERENCES, WE OBSERVE AN UPWARD TREND IN PHARMACEUTICAL EXPENDITURES IN PER CAPITA TERMS, PERCENTAGE OF GDP, AND PROPORTION OF TOTAL HEALTH EXPENDITURE 3 COST-CONTAINMENT MEASURES GOVERNMENTS (THE MAIN THIRD-PARTY PAYERS IN MANY EUROPEAN COUNTRIES) AND INSURANCE INSTITUTIONS HAVE ADOPTED MANY STRATEGIES TO COPE AND TO (PROBABLY) CONTROL THE INCREASE IN PHARMACEUTICAL SPENDING THESE STRATEGIES HAVE FOCUSED ON BOTH THE DEMAND AND THE SUPPLY SIDE OF THE MARKET SOME MEASURES SEEK TO COUNTERACT MARKET FAILURES, WHILE OTHERS INTEND ONLY TO CONTROL EXPENDITURE ADDITIONAL MEASURES ARE AIMED AT THE PHARMACEUTICAL INDUSTRY’S MARKET POWER DEMAND-SIDE INTERVENTIONS ARE AIMED AT PATIENTS AND PHYSICIANS, AND ATTEMPT TO IN?UENCE THE LEVEL AND COMPOSITION OF DEMAND AT SEVERAL POINTS TABLE 3 PHARMACEUTICAL EXPENDITURE PER CAPITA (PPP) (IN US$) BELGIUM CZECH REPUBLIC DENMARK FINLAND FRANCE GERMANY GREECE HUNGARY ICELAND ITALY LUXEMBOURG THE NETHERLANDS NORWAY PORTUGAL SLOVAK REPUBLIC SPAIN SWEDEN SWITZERLAND TURKEY UNITED KINGDOM