Trends in decision-making process for pharmaceuticals in Western European countries. A focus on emerging hurdles for obtaining reimbursement and a price.

Resumen

Health care financing has become a topic on the political agenda in Western Europe in recent decades. For every government it has become a subject of continuous concern because the costs of health services and health care are an increasing important part of the collective burden of the economy. Most cost containment measures have relied on budgeting or price controls. Because those traditional central cost containment measures were only partially successful, due to lack of incentives, the health authorities in Europe started to establish incentives for efficient health care delivery by means of decentralisation of the health care decision-making process and the implementation of market mechanisms. Both traditional and recent containment measures focus especially on the pharmaceutical drugs sector in many countries. Recently there have been three parallel trends showing increasing data requirements at a central level, more decentralisation of the responsibilities and decision-making process and prescription restrictions. We address especially the increasing central data requirements and decentralisation of the pricing and/or reimbursement decision-making process. At a central level the demand is increasing for cost-effectiveness and budgetary impact data, which has already resulted in formal reporting requirements in some countries. The findings are based on the literature and expert opinion of local health policy experts in the various European Union countries, who co-authored this manuscript.