Public financing

The Audit Commission for England and Wales promotes proper stewardship of public finances and helps local authorities and the NHS to deliver economic, efficient and effective public services. The Commission also owns District Audit, which it appoints to carry out many of the audits for which the Commission is responsible. District Audit operates as an arm s-length agency. 

Germany None. Elat rate of co-payment for the first 14 days per year of hospitalization, after which there is no cost sharing of any sort Variable co-payment. RP system. No coverage is applied to those pharmaceuticals on public financing negative lists... 

This book consists of a series of works that evaluate various aspects related to the public financing of pharmaceuticals. In all health systems with majority public funding, the financing of pharmaceuticals constitutes one of the key factors in reform policies and health cost containment measures. This importance of pharmaceutical spending can be explained by both its relative size (its share within health expenditure as a whole), and its rapid growth, which is closely related to the constant incorporation of therapeutic innovations. 

The second series of contributions focus on the analysis of the application and effectiveness of the main instruments public financing agencies use to regulate pharmaceutical expenditure, on both the demand side and the supply side. 

European pharmaceutical markets are strongly regulated as regards the introduction of new products onto the market (through authorization and patents) and also as regards prices and consumption (medical prescription and public financing). However, the way in which entry, prices and consumption of pharmaceuticals are regulated varies enormously from country to country. 

In recent years in some developed countries, the requisite of presenting economic evaluation (that is, pharmacoeconomic) studies of new dmgs has been introduced alongside the existing one of clinical trials. These studies have to provide proof of their efficiency (or cost-effectiveness) as a condition for the public financing of the new product. These studies improve information and market transparency and may help to make competition keener, but like the earlier requirements regarding effectiveness and safety, they constitute an additional cost factor and as such raise further barriers to entry. 

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