Reimbursement of medicines

Drummond, M., B. Jonsson and F. Rutten (1997), The role of economics evaluation in the pricing and reimbursement of medicines , Health Policy, 40, 199-215. 

Maassen, B.M. (1998), Reimbursement of medicinal products the German reference price system - law, administrative practice and economics , Cuademos de Derecho Europeo Farmaceutico, 8, 69-100. 

O Donoghue, N. (1994), Pricing and reimbursement of medicines the Irish experience , in E. Mossialos (ed.) (1994), Cost Containment, Pricing and Financing of Pharmaceuticals in the European Community the Policy-makers View, London London School of Economics and Pharmetrica, pp. 281-301. 

In the end it is the Minister of Social Affairs who decides on the reimbursement of medicines. If the outcome is positive the reimbursement modalities are published in the National Gazette. This publication will also determine the day when the reimbursement will be implemented. 

The pricing and reimbursement of medicines cire still special issues in Hungary. Until 1997, legal (prescription) and reimbursement status were not fully separated and both were specified by the Ministry of Health. Application of a more restricted prescription status for expensive medicines was not uncommon. Since 1997, the legal status is specified, applying professional criteria exclusively, by the regulatory authority when the MA is issued. 

The Pharmaceutical Pricing Compendium—A practical guide to the pricing and reimbursement of medicines. Urch Publishing Ltd. March 2003 140 pp. 

Currently a number of countries (Australia, Canada, Einland, Norway, UK, The Netherlands) are using pharmaco-economic evaluation, experimentally or definitively, as an additional tool in the decisionmaking process regarding the pricing and reimbursement of medicines one of the most developed of such systems is that applied by the Australian Ministry of Health. 

Despite the progress which has been made, the increasing health needs and expectations of patients and society generally, as well as those of health professionals, have not yet been matched in this part of Europe by an increase in resources within the health sector. For the supply and reimbursement of medicines this has meant that part of the costs of medicines (often a substantial part) are having to be borne by the patient, either through co-payment for reimbursed drugs or through direct purchases of OTC medicines or non-reimbursable items. 

The assessment of the clinical benefit of medicines is generally understood by clinicians, regulatory authorities and reimbursement authorities alike. Everyone instinctively understands the clinical benefit of decreasing a hypertensive patient s blood pressure to 130/90 or the benefit in reducing the number of strokes. However, in an era of increasing healthcare costs and funding decisions, there is a need not only to illustrate the clinical benefit of a drug, but to translate that clinical outcome into an economic benefit. 

We live in an era in which the value of medicines can no longer be assumed and the phrase evidence based is no longer restricted to the realm of academics. The increasing financial burden on our healthcare systems has prompted decision-makers around the world to demand that the pharmaceutical industry provide proof of the value of new drugs being introduced into the market. Decision-makers in certain countries (e.g. Australia and Canada) have taken this requirement a step further by linking reimbursement approval to the provision... 

The Food Chemicals Codex (FCC) project is an activity of the Food and Nutrition Board, a unit of the Institute of Medicine of the National Academies. The immediate responsibility for developing the Food Chemicals Codex lies with the Board s Committee on Food Chemicals Codex. The committee consists of 12 to 15 members, chosen for their expertise in the various aspects of the committee s work, who are appointed, upon recommendation of the Food and Nutrition Board and the President of the Institute of Medicine, by the Chairman of the National Research Council. Committee members are paid no consulting fees or honoraria and are reimbursed only for expenses incurred while attending meetings and other activities of the committee.1... 

The strong tendency towards phytotherapy and self-medication is further supported by health insurance companies which exclude medication for minor diseases from the list of reimbursed products. So-called lifestyle drugs cmd functional food are the industry s reaction towards such trends. Patients take care of their heedth in a more responsible manner and try to prevent severe and chronic diseases by changing their lifestyle and controlling their food intake. Dietary measures instead of medicine represent the new approach toward a healthier life. A profound distrust of genetically engineered food has paved the way to a back to nature trend with a preference for products with the bio label. 

Because of the former restrictions (as well as the practice of the National Health Insurcmce administration that does not reimburse nonprescription medicines), the number of nonprescription medicines remained relatively small in Hungary. In April 1995, however, more than 100 prescriptions-only were switched (Paal 1996d). In 1998, more than 500 nonprescription medicines were registered which, together with paramedicines, gave an OTC-selection which covered about 25 percent of the toted remedies. In addition, there are more than 1,000 homeopathic medicines which, with the exception of a the few injections, are all nonprescription medicines. 

Product is removed from the list of medicines reimbursed by French social security schemes. Advertising directed at healthcare professionals ... 

Spain Must be inexpensive and related to the practice of medicine or pharmacy No guidance found No guidance found No guidance found Payment of reasonable fees and reimbursement of expenses for speakers is permissible Permitted with some specific conditions. See code... 

Directive 89/105/EEC of December 21,1988, relating to the transparency of measures regulating the pricing of medicinal products for human use and their inclusion within the scope of national health insurance systems (transparency of price and reimbursement). 

---