Advertisement

Applied Health Economics and Health Policy

, Volume 8, Issue 1, pp 7–24 | Cite as

Ongoing pharmaceutical reforms in France

Implications for key stakeholder groups
  • Catherine SermetEmail author
  • Veronique Andrieu
  • Brian GodmanEmail author
  • Eric Van Ganse
  • Alan Haycox
  • Jean-Pierre Reynier
Current Opinion

Abstract

The rapid rise in pharmaceutical costs in France has been driven by new technologies and the growing prevalence of chronic diseases as well as considerable prescribing freedom and choice of physician among patients. This has led to the introduction of a number of reforms and initiatives in an attempt to moderate expenditure whilst ensuring universal coverage and rewarding innovation. These reforms include accelerating access to and granting average European prices for new innovative drugs, delisting drugs where there are concerns over their value and instigating rebates for excessive prescribing. Alongside this, ongoing initiatives to improve the quality and efficiency of prescribing include programmes to enhance generic prescribing and dispensing as well as to reduce antibacterial and anxiolytic/hypnotic prescribing.

However, there have been few publications documenting the impact of specific reforms on the overall costs and quality of care, which have been exacerbated by compartmentalization of budgets. Estimates suggest savings of over €27 million/year by decreasing antibacterial prescribing, €450 million/year by not reimbursing ineffective drugs, €670 million/year from pharmaceutical company rebates and approximately €1 billion/year from increased prescribing and dispensing of generics (year 2003–7 values). Additional savings of at least €1.5 billion/year are seen as being possible from increased use of generics such as generic proton pump inhibitors, statins (HMG-CoA reductase inhibitors) and ACE inhibitors instead of current branded products such as angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]).

Delisting drugs when there are concerns about their value provides an example to other countries with currently limited demand-side measures. Other possible examples include price : volume agreements and multifaceted campaigns to enhance generic prescribing and dispensing and reduce antibacterial prescribing.

Possible future initiatives could include adopting more stringent criteria for categorizing new drugs as innovative as well as further reductions in the prices of generics. Other initiatives could include further enhancement of the quality and efficiency of prescribing, including formal auditing of physician prescribing, as well as increasing efforts to monitor the risk : benefit ratio of new drugs post-launch in real-world practice.

Keywords

Ambulatory Care Community Pharmacist Reference Price Pharmaceutical Expenditure Originator Product 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

No sources of funding were used to assist in the preparation of this article. The authors have no conflicts of interest that are directly relevant to the content of this article.

The authors would like to thank Jacqueline Grassin for her help with supplying data on future initiatives in hospitals. The authors also thank Sylvain Pichetti for his help with proof reading and correcting earlier drafts.

References

  1. 1.
    Garattini L, Motterlini N, Cornago D. Prices and distribution margins of in-patent drugs in pharmacy: a comparison in seven European countries. Health Policy 2008; 85: 305–13PubMedCrossRefGoogle Scholar
  2. 2.
    Organisation for Economic Co-operation and Development. OECD health data 2009: frequently requested data. Paris: OECD, 2009 [online]. Available via URL: http://www.oecd.org/document/16/0,3343,en_2649_34631_2085200_1_ 1_1_1,00.html [Accessed 2009 Nov 1]Google Scholar
  3. 3.
    L’Assurance Maladie. Chiffres & repères 2006 ed. [online]. Available from URL: http://www.ameli.fr/l-assurancemaladie/statistiques-et-publications/points-de-repere/index.php [Accessed 2008 Jul 7]
  4. 4.
    Grandfils N, Sermet C. Pharmaceutical policy in France: a mosaic of reforms. Eurohealth 2006; 12(3): 15–7Google Scholar
  5. 5.
    Degos L, Romaneix F, Michel P, et al. Can France keep its patients happy? BMJ 2008; 336: 254–57PubMedCrossRefGoogle Scholar
  6. 6.
    Sabban C, Courtois J. Comparaisons européennes sur huit classes de médicaments. ’Assurance maladie. Points de repère décembre 2007 — numéro 12 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/Points_de_repere_n__12.pdf [Accessed 2009 Feb 17]
  7. 7.
    l’Assurance Maladie. Résultats de l’enquête de satisfaction 2007: les assurés jugent la qualité des services de l’Assurance Maladie [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/Enquete_assures.pdf [Accessed 2009 Jul 7]
  8. 8.
    European Observatory on Health Systems and Policies. Health care systems in transition: HiT summary. Copenhagen: European Observatory on Health Systems and Policies, WHO regional office for Europe, 2004 [online]. Available from URL: http://www.euro.who.int/document/e83126sum.pdf [Accessed 2009 Mar 6]Google Scholar
  9. 9.
    Cases C. French health system reform: recent implementation and future challenges. Eurohealth 2006; 12: 10–11Google Scholar
  10. 10.
    Coleman M, Quaresma M, Berrino F, et al. Cancer survival in five continents: a worldwide population-based study (CONCORD). Lancet Oncol 2008; 9: 730–56PubMedCrossRefGoogle Scholar
  11. 11.
    Björnberg A, Uhlir M. Eurohealth consumer index 2008 report. Brussels: Health Consumer Powerhouse AB, 2008 [online]. Available from URL: http://www.healthpower house.com/files/2008-EHCI/EHCI-2008-report.pdf [Accessed 2009 Mar 1]Google Scholar
  12. 12.
    Van Ganse E, Chamba G, Becquart B, et al. Pharmaceutical pricing and reimbursement information: France October 2007 [online]. Available from URL: http://ppri.oebig.at/Downloads/Results/France_PPRI_2007.pdf [Accessed 2009 Jan 20]Google Scholar
  13. 13.
    Kusnik-Joinville O, Weill A, Salanave B, et al. Prevalence and treatment of diabetes in France: trends between 2000 and 2005. Diabetes Metab 2008; 34: 266–72PubMedCrossRefGoogle Scholar
  14. 14.
    Dufour C. La France, 10,5 millions d’hypertendus traits. L’Assurance Maladie, 2008 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/AMDP-DP_HTA_VDEF1.pdf [Accessed 2008 Jul 7]Google Scholar
  15. 15.
    L’Assurance Maladie. Mieux utiliser les traitements anticholestérol: l’Assurance Maladie renforce son action pour favoriser le respect des recommandations sanitaires [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/DP_Statines_vdef.pdf [Accessed 2008 Jul 7]
  16. 16.
    Grandfils N. Drug price setting and regulation in France [working paper DT no. 16]. Paris: IRDES, 2008 Sep [online]. Available from URL: http://www.irdes.fr/EspaceAnglais/Publications/WorkingPapers/DT16DrugPriceSet tingRegulationFrance.pdf [Accessed 2008 Nov 20]Google Scholar
  17. 17.
    Nguyen-Kim L, Or Z, Paris V, et al. The politics of drug reimbursement in England, France, and Germany. IRDES Health Economics Letter 2005 Oct; 99 [online]. Available from URL: http://www.irdes.fr/EspaceAnglais/Publications/IrdesPublications/QES099.pdf [Accessed 2008 Apr 16]Google Scholar
  18. 18.
    Paris V. Pharmaceutical regulation in France 1980–2003. Int J Health Plann Manage 2005; 20: 307–28PubMedCrossRefGoogle Scholar
  19. 19.
    Mossialos E, Oliver A. An overview of pharmaceutical policy in four countries: France, Germany, the Netherlands and the United Kingdom. Int J Health Plann Manage 2005; 20: 291–306PubMedCrossRefGoogle Scholar
  20. 20.
    Le Pen C. The drug budget silo mentality: the French case. Value Health 2003; 6 Suppl. 1: S10–9PubMedCrossRefGoogle Scholar
  21. 21.
    Sandier S, Paris V, Polton D. Health care systems in transition: France. Copenhagen: WHO Regional office for Europe on behalf of the European Observatory on Health Systems and Policies, 2004 [online]. Available from URL: http://www.euro.who.int/document/e83126.pdf [Accessed 2008 Mar 6]Google Scholar
  22. 22.
    Paris V. Pharmaceutical regulation in France 1980–2003. Int J Health Plann Manage 2005; 20: 307–28PubMedCrossRefGoogle Scholar
  23. 23.
    Couffinhal A, Paris V. Cost sharing in France: a working paper. 2003 Aug [online]. Available from URL: http://www.irdes.fr/EspaceAnglais/Publications/OtherPubs/CostSharingInFrance.pdf [Accessed 2009 Nov 30]Google Scholar
  24. 24.
    Nouveaux cas des affections de longue durée (ALD 30) de 1990 à 2006: France entière [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/Tableau_evolution_ald.pdf [Accessed 2008 Nov 20]
  25. 25.
    Legifrance. Social security code: article R-163-6 [online]. Available from URL: http://www.legifrance.gouv.fr/affichCodeArticle.do?cidTexte=LEGITEXT000006073189 &idArticle=LEGIARTI000006747689&dateTexte=&cate gorieLien=cid [Accessed 2008 Nov 20]
  26. 26.
    ARCOBASE® (registered to the Agence pour la Protection des Programmes) [database; online]. Available from URL: http://www.arcosa.net/ [Accessed 2009 Nov 16]
  27. 27.
    Report on the activities of the Transparency Commission in 2004. Commission de la Transparence: 2005 Oct 10 [in French; online]. Available from URL: http://www.has sante.fr/portail/upload/docs/application/pdf/ctrapact2004.pdf [Accessed 2009 Feb 02]
  28. 28.
    Avis sur le médicament, adopté par le Haut Conseil pour l’Avenir de l’Assurance Maladie. Haut Conseil pour l’Avenir de l’Assurance Maladie: 2006 Jun 29 [online]. Available from URL: http://www.securite-sociale.fr/institutions/hcaam/avis/hcaam_avis_060629.pdf [Accessed 2009 Feb 02]
  29. 29.
    Médicaments de la maladie d’Alzheimer: réévaluation à la baisse de l’amélioration du service rendu. Prescrire 2008 Mar 15 [online]. Available from URL: http://www.prescrire. org/aLaUne/dossierAlzheimerASMR.php [Accessed 2008 Nov 20]
  30. 30.
    Esomeprazole (Inexium): ASMR V et baisse de prix, enfin! Rev Prescrire 2009; 29(313): 816 [online]. Available from URL: http://www.prescrire.org/aLaUne/dossierEsomeprazole.php [Accessed 2009 Dec 1]
  31. 31.
    Van Ganse E, Vukusic S, Zanetti L, et al. TYSEDMUS: cohort of multiple sclerosis patients treated with TYSAPRI using the French European database for multiple sclerosis (EDMUS) — methodological aspects. Pharmacoepidemiol Drug Saf 2008; 17: S1–294CrossRefGoogle Scholar
  32. 32.
    French industry fed up with ’shortsighted’ pharmaceutical policies [abstract]. Scrip 2006; 3198: 5Google Scholar
  33. 33.
    Office of Fair Trading (UK). The pharmaceutical price regulation system: an OFT study. Annexe K: international survey of pharmaceutical pricing and reimbursement schemes. London: The Office of Fair Trading, 2007 Feb [online]. Available from URL: http://www.oft.gov.uk/shared_oft/reports/comp_policy/oft885k.pdf [Accessed 2009 Mar 6]Google Scholar
  34. 34.
    Arrêté du 18 avril 2003 modifant la liste des spécialités pharmaceutiques remboursables aux assurés sociaux. Journal Officiel de la Rebublique Francaise 2003 Apr 19 [online]. Available from URL: http://www.sante.gouv.fr/htm/actu/liste_smr.pdf [Accessed 2008 Nov 20]
  35. 35.
    Baisse du taux de remboursement de certains médicaments à SMR modéré ou faible [online]. Available from URL: http://www.sante.gouv.fr/htm/actu/31_030422.htm [Accessed 2008 Nov 20]
  36. 36.
    Naudin F, Sermet C. Drug delisting and reduced reimbursement: policy survey 2003 (2). Health Policy Monitor, Bertelsmann Stiftung’s International Network for Health Policy and Reform [online]. Available from URL: http://www.irdes.fr/EspaceAnglais/Publications/Medicines.html [Accessed 2009 Oct 30]
  37. 37.
    Anon. Document d’information générale réservé à l’usage de la presse 72 products removed [online]. Available from URL: http://www.sante.gouv.fr/htm/actu/medicament/liste.pdf [Accessed 2008 Nov 20] ai38._Third phase of French reimbursement cull begins. Scrip 2006; 3135: 6Google Scholar
  38. 39.
    Prise en charge des médicaments soumis à réévaluation — troisième vague de réévaluation des médicaments à service médical rendu insuffisant, les classes thérapeutiques concernées 2006 [online]. Available from URL: http://www.hassante.fr/portail/jcms/c_456052/prise-en-charge-des-medicaments-soumis-a-reevaluation#c_456102 [Accessed 2008 Nov 20]Google Scholar
  39. 40.
    DISCOURS: ‘3ème vague de médicaments réévalués’ 2006 [online]. Available from URL: http://www.sante.gouv.fr/htm/actu/33_061025xb.htm [Accessed 2008 Nov 20]
  40. 41.
    Simoens S, De Coster S. Sustaining generic markets in Europe. Leuven: Katholieke Universiteit Leuven, Research Centre for Pharmaceutical Care and Pharmacoeconomics, 2006 [online]. Available from URL: http://www.egagenerics.com/doc/simoens-report_2006- 04.pdf [Accessed 2006 Oct 16]Google Scholar
  41. 42.
    Grandfils N. Implementation of reference prices: policy survey 2005 (6). Health Policy Monitor, Bertelsmann Stiftung’s international network for health policy and reform [online]. Available from URL: http://www.irdes.fr/EspaceAnglais/Publications/Medicines.html [Accessed 2009 Oct 30]
  42. 43.
    Simoens S. Trends in generic prescribing and dispensing in Europe. Expert Rev Clin Pharmacol 2008; 1(4): 497–503CrossRefGoogle Scholar
  43. 44.
    Decree n∘2002-1216. Journal Officiel de la République française 2002 Sep 30: page 16260 [online]. Available from URL: http://www.droit.org/jo/2002/16260.html [Accessed 2008 Dec 10]
  44. 45.
    Spurgeon B. Opposition grows to new charges for drugs and ambulance trips. BMJ 2007; 335: 1228–9PubMedCrossRefGoogle Scholar
  45. 46.
    Chatel law. Les prix des médicaments remboursables sont les derniers prix industriels à être administrés 2008 [online]. Available from URL: http://www.leem.org/medicament/les-prix-des-medicaments-remboursables-sont-les-derniers-prix-industriels-a-etre-405.htm [Accessed 2008 Nov 20]Google Scholar
  46. 47.
    Kanavos P, Taylor D. Pharmacy discounts on generic medicines in France: is there room for further efficiency savings? Curr Med Res Opin 2007; 23: 2467–76PubMedCrossRefGoogle Scholar
  47. 48.
    Godman B, Haycox A, Schwabe U, et al. Having your cake and eating it: Office of Fair Trading proposal for funding new drugs to benefit patients and innovative companies. Pharmacoeconomics 2008; 26(2): 91–8PubMedCrossRefGoogle Scholar
  48. 49.
    AFSSAPS. Notice to applicants for temporary authorisation for use (ATU). May 2006 [online]. Available from URL: http://www.afssaps.fr/Activites/Autorisations-temporaires-d-utilisation/ATU-Reglementation/(offset)/7 [Accessed 2008 Nov 20]Google Scholar
  49. 50.
    Notice to applicants for temporary authorisation for use (ATU). November 2007 [online]. Available from URL: http://www.afssaps.fr/var/afssaps_site/storage/original/application/32f7b4f77a894fa586797500dd52063c.pdf [Accessed 2009 Nov 30]
  50. 51.
    Launet O, Brouard A, Doreau C. Drugs under temporary use authorisation: 50 years of French drug development [in French]. Rev Hist Pharm (Paris) 2004; 52(341): 47–54Google Scholar
  51. 52.
    ATU de cohorte en cours: spécialités, résumés des caractéristiques du produit (RCP) et notices destinées aux patients. October 2008 [online]. Available from URL: http://www.afssaps.fr/Activites/Autorisations-temporairesd-utilisation/ATU-de-cohorte/(offset)/2#paragraph_5196 [Accessed Nov 20 2008]
  52. 53.
    Or Z, de Pouvourville G. French hospital reforms: a new era of public-private competition? Eurohealth 2006; 12(3): 21–3Google Scholar
  53. 54.
    Référentiels nationaux pour un bon usage des médicaments onéreux et innovants April 2007 [online]. Available from URL: http://www.afssaps.fr/var/afssaps_site/storage/original/application/16c927d47483c198c65af59667c14b57. pdf [Accessed 2009 Nov 30]
  54. 55.
    Falgarone G, Duclos M, Boissier M-C. TNF alpha antagonists in rheumatoid arthritis patients seen in everyday practice [editorial]. Joint Bone Spine 2007; 74: 523–6PubMedCrossRefGoogle Scholar
  55. 56.
    Fautrel B, Pham T, L’Mouterde G, et al. Recommendations of the French Society for Rheumatology regarding TNF alpha antagonist therapy in patients with rheumatoid arthritis. Joint Bone Spine 2007; 74: 627–37PubMedCrossRefGoogle Scholar
  56. 57.
    Allenet B, Barry H. Opinion and behaviour of pharmacists towards the substitution of brand products by generic drugs: survey of 1000 French community pharmacists. Pharm World Sci 2003; 25(5): 197–202PubMedCrossRefGoogle Scholar
  57. 58.
    Avis sur le médicament, adopté le 25 septembre 2008 par le Haut Conseil pour l’Avenir de l’Assurance Maladie. Haut Conseil pour l’Avenir de l’Assurance Maladie: 2008 Sep 25 [online]. Available from URL: http://www.securitesociale.fr/institutions/hcaam/avis/hcaam_avis_250908.pdf [Accessed 2009 Mar 1]
  58. 59.
    Godman B, Wettermark B, Hoffman M, et al. Multifaceted national and regional drug reforms and initiatives in ambulatory care in Sweden: global relevance. Expert Rev Pharmacoecon Outcomes Res 2009; 9: 65–83PubMedCrossRefGoogle Scholar
  59. 60.
    L’Assurance Maladie. Médicaments génériques: nouvelle progression du taux de penetration. 2007 Jul 5 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/generiques_juil_2007.pdf [Accessed 2008 Feb 17]
  60. 61.
    L’Assuramce Maladie. Médicaments génériques: point d’étape à fin avril 2008 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/DP_generiques_5_juin_08.pdf [Accessed 2008 Jul 11]
  61. 62.
    L’Assurance Maladie. Consommation et dépenses de médicaments: comparaison des pratiques françaises et européennes [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/Consommation_et_depenses_de_medicaments_-_Europe.pdf [Accessed 2008 Jul 7]
  62. 63.
    L’Assurance Maladie. La France championne d’Europe en dépenses de medicaments 2008 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/docu ments/DP_La_France_championne_d_Europe_v2.pdf [Accessed 2008 Jul 7]
  63. 64.
    Rochaix L, Wilsford D. State autonomy, policy paralysis: paradoxes of institutions and culture in the French health care system. J Health Polit Policy Law 2005; 30(1–2) 97–119PubMedCrossRefGoogle Scholar
  64. 65.
    Durieux P, Gaillac B, Giraudeau B, et al. Despite financial penalties, French physicians’ knowledge of regulatory practice guidelines is poor. Arch Fam Med 2000; 9: 414–8PubMedCrossRefGoogle Scholar
  65. 66.
    Pepin S, Ricordeau P. La consommation d’antibiotiques: situation en France au regard des autres pays Européens. L’Assurance Maladie 2006 Nov; 6 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/pointreperen_6.pdf [Accessed 2008 Feb 17]Google Scholar
  66. 67.
    L’Assurance Maladie. La maitrise medicalisee des depenses d’assurance maladie dans les deux-sevres. Bilan 2005/2006 et perspectives. 2006 Sep 28 [online]. Available from URL: http://www.ameli. fr/fileadmin/user_upload/documents/mai trise_medicalise.pdf [Accessed 2008 Jul 10]
  67. 68.
    L’Assurance Maladie. Programme antibiotiques: un premier cap est franchi, la mobilisation pour le bon usage doit se poursuivre. 2008 Jan 10 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/DP_Antibiotiques_10-01-2008.pdf [Accessed 2008 Feb 17]
  68. 69.
    L’Assurance Maladie. Programme antibiotiques 2007/2008. L’Assurance Maladie repart en campagne sur les antibiotiques. 2007 Nov 27 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/CP_campagne_antibiotiques_2007-2008.pdf [Accessed 2008 Feb 17]
  69. 70.
    L’Assurance Maladie. Maîtrise médicalisée des dépenses de santé: l’Assurance Maladie met en place un programme d’information des professionnels de santé. 2005 Mar 14 [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/cp 14032005.pdf [Accessed 2008 Jul 10]
  70. 71.
    Chevreul K. Evaluation of professionals’ practice. Policy survey 2005 (5). Health Policy Monitor for Bertelsmann Stiftung’s International Network for Health Policy and Reform [online]. Available from URL: http://www.hpm.org/en/Surveys/IRDES_-_France/05/Evaluation_of_professionals__practice.html?search=start+search&content_id=251&sortOrdersortAsc&lastSortOrder=sortAsc&language=en&a=sh&search.x=46&sortBy=sortCountry&p_c:184=184 &p_i=0&search.y=9&lastSortBy=sortCountry&pageOffset =1 [Accessed 2008 Nov 20]
  71. 72.
  72. 73.
    Dourgnon D, Guillaume S, Naiditch M, et al. Introducing gate keeping in France: final assessment of the preferred doctor scheme reform. IRDES Issues in Health Economics 2007 Jul; 124 [online]. Available from URL: http://www. irdes.fr/Espace Anglais/Publications/IrdesPublications/QES124.pdf [Accessed 2008 Jan 5]Google Scholar
  73. 74.
    Cases C, Chevreul K, Meunier N, et al. Interview with Xavier Bertrand, French Minister of Health. Eurohealth 2006; 12(3): 12–5Google Scholar
  74. 75.
    La couveture complementaire en France en 2006 [online]. Available from URL: http://www.irdes.fr/EspaceEnseignement/ChiffresGraphiques/CouvertureComplementaire/Donnees Gnles/DonneesGnles.html [Accessed 2009 Mar 1]
  75. 76.
    LEEM. Les remboursements de l’ensemble des régimes de sécurité sociale [online]. Available from URL: http://www.leem.org/medicament/les-remboursements-de-l-ensemble-des-regimes-de-securite-sociale-454.htm [Accessed 2009 Mar 1]
  76. 77.
    L’Assurance Maladie. Dépenses de médicaments en 2007: Quels sont les principaux moteurs de la croissance? [online]. Available from URL: http://www.ameli.fr/fileadmin/user_upload/documents/Note_croissance_medicaments_2007.pdf [Accessed 2008 Jul 7]
  77. 78.
    Godman B, Bucsics A, Burkhardt T, et al. Insight into recent reforms and initiatives in Austria: implications for key stakeholders. Expert Rev Pharmacoecon Outcomes Res 2008; 8(4): 357–71PubMedCrossRefGoogle Scholar
  78. 79.
    Fattore G, Jommi C. The last decade of Italian pharmaceutical policy: instability or consolidation? Pharmaco-economics 2008; 26(1): 5–15CrossRefGoogle Scholar
  79. 80.
    Motola D, De Ponti F, Rossi P, et al. Therapeutic innovation in the EU: analysis of the drugs approved by the EMEA between 1995 and 2003. Br J Clin Pharmacol 2004; 59: 475–8CrossRefGoogle Scholar
  80. 81.
    Motola D, De Ponti F, Poluzzi E, et al. An update on the first decade of the European centralized procedure: how many innovative drugs? Br J Clin Pharmacol 2006; 62: 610–6PubMedCrossRefGoogle Scholar
  81. 82.
    AIFA — Italian Medicines Agency. Working Group on Innovative Drugs. Criteria for ranking therapeutic innovation of new drugs and elements for supplementing the dossier for admission to the reimbursement system (document approved by the AIFACTS on July 10, 2007) [online]. Available from URL: http://www.agenziafarmaco.it/allegati/integral_document.pdf [Accessed 2008 Nov 20]
  82. 83.
    European and French pharmaceutical market assessed by Prescrire in 2005: mainly bogus innovation [editorial]. Farmacia Hospitalaria 2006; 30(2): 68–70Google Scholar
  83. 84.
    Garattini S, Bertele’ V. How can we regulate medicines better. BMJ 2007; 335: 803–5PubMedCrossRefGoogle Scholar
  84. 85.
    Addis A. An original research project. 2005 Dec 20 [online]. Available from URL: http://www.psocare.it/en-newsletter-01.pdf [Accessed 2008 Feb 13]Google Scholar
  85. 86.
    Folino Gallo P, Deambrosis P. Pharmaceutical risk-sharing and conditional reimbursement in Italy. 2008 Nov [online]. Available from URL: http://www.ceestahc.org/pliki/symp2008/gallo.pdf [Accessed 2009 Feb 20]Google Scholar
  86. 87.
    Wettermark B, Godman B, Andersson K, et al. Recent national and regional drug reforms in Sweden: implications for pharmaceutical companies in Europe. Pharmacoeconomics 2008; 26(7): 537–50PubMedCrossRefGoogle Scholar
  87. 88.
    Askling J, Fored CM, Geborek P, et al. Swedish registers to examine drug safety and clinical issues in RA. Ann Rheum Dis 2006; 65: 707–12PubMedCrossRefGoogle Scholar
  88. 89.
    Lee T, Emanuel E. Tier 4 drugs and fraying of the social concept. N Engl J Med 2008; 359: 333–5PubMedCrossRefGoogle Scholar
  89. 90.
    Gliklich RE, Dreyer NA, editors. Registries for evaluating patient outcomes: a user’s guide (prepared by Outcome DEcIDE Center [Outcome Sciences, Inc. dba Outcome] under contract no. HHSA29020050035I TO1). AHRQ publication no. 07-EHC001-1. Rockville (MD): Agency for Healthcare Research and Quality, 2007 AprGoogle Scholar
  90. 91.
    Taylor L. New UK PPRS includes 3.9% price cut, flexible pricing and generic substitution. 2008 Nov 20 [online]. Available from URL: http://www.eatg.org/eatg/New-UK-PPRS-includes-3.9-price-cut-flexible-pricing-and-generic-substitution [Accessed 2009 Jan 4]Google Scholar
  91. 92.
    De Swaef A, Antonissen Y. Pharmaceutical pricing and reimbursement information, Belgium, 2007 Nov [online]. Available from URL: http://ppri.oebig.at/Downloads/Results/Belgium_PPRI_2008.pdf [Accessed 2009 Jan 5]Google Scholar
  92. 93.
    Pudersell K, Vetka A, Rootslane L, et al., Pharmaceutical pricing and reimbursement information, Estonia June 2007 [online]. Available from URL: http://ppri.oebig.at/Downloads/Results/Estonia_PPRI_2007.pdf [Accessed 2009 Jan 5]Google Scholar
  93. 94.
    Koppel A, Kahur K, Habicht T, et al. Estonia health system review. Health Syst Transit 2008; 10(1) [online]. Available from URL: http://www.euro.who.int/Document/E91372.pdf [Accessed 2009 Jan 5]Google Scholar
  94. 95.
    Kovács T, Rózsa P, Szigeti S, et al. Pharmaceutical pricing and reimbursement information, Hungary, 2007 Jun [online]. Available from URL: http://ppri.oebig.at/Downloads/Results/Hungary_PPRI_2007.pdf [Accessed 2009 Jan 5]Google Scholar
  95. 96.
    Teixeira I, Vieira I. Pharmaceutical pricing and reimbursement information, Portugal, 2008 Oct [online]. Available from URL: http://ppri.oebig.at/Downloads/Results/Portugal_PPRI_2008.pdf [Accessed 2009 Jan 5]Google Scholar
  96. 97.
    Godman B, Schwabe U, Selke G, et al. Update of recent reforms in Germany to enhance the quality and efficiency of prescribing of proton pump inhibitors and lipid-low-ering drugs [research letter]. Pharmacoeconomics 2009; 27(5): 435–8PubMedCrossRefGoogle Scholar
  97. 98.
    Von Ferber L, Bausch J, Köster I, et al. Pharmacotherapeutic circles: results of an 18-month peer-review prescribingimprovement programme for general practitioners. Pharmacoeconomics 1999; 16(3): 273–83CrossRefGoogle Scholar
  98. 99.
    Mason AR, Drummond MF, Hunter JA, et al. Prescribing incentive schemes: a useful approach? Appl Health Econ Health Policy 2005; 4(2): 111–7PubMedCrossRefGoogle Scholar
  99. 100.
    Beishon J, McBride T, Scharaschkin S, et al. Prescribing costs in primary care. London: National Audit Office, 2007 May 18 [online]. Available from URL: http://www.nao.org.uk/publications/nao_reports/06-07/0607454.pdf [Accessed 2008 May 21]Google Scholar
  100. 101.
    Mason A. New medicines in primary care: a review of influences on general practitioner prescribing. J Clin Pharm Ther 2008;33: 1–10PubMedCrossRefGoogle Scholar
  101. 102.
    Atella V, Schafheutle E, Noyce P, et al. Affordability of medicines and patients’ cost-reducing behaviour: empirical evidence based on SUR estimates from Italy and UK. Appl Health Econ Health Policy 2005; 4(1): 23–35PubMedCrossRefGoogle Scholar
  102. 103.
    Garattini L, Ghislandi S. Off-patent drugs in Italy: a shortsighted view? Eur J Health Econ 2006; 7: 79–83PubMedCrossRefGoogle Scholar
  103. 104.
    Puig-Junoy J. Incentives and pharmaceutical reimbursement reforms in Spain. Health Policy 2004; 67: 149–65PubMedCrossRefGoogle Scholar
  104. 105.
    Seeley E, Kanavos P. Generic medicines from a societal perspective: savings for healthcare systems? Eurohealth 2008; 14(2): 18–22Google Scholar
  105. 106.
    Farmaci generici: dubbi o pregiudizi? Dialogo sui farmaci 2007; 2: 75–7Google Scholar
  106. 107.
    Wettermark B, Hammar N, Fored CM, et al. The new Swedish Prescribed Drug Register: opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf 2007; 16: 726–35PubMedCrossRefGoogle Scholar
  107. 108.
    Malmvall B, Molstad S, Darelid J, et al. Reduction of antibiotics sales and sustained low incidence of bacterial resistance: report on a broad approach during 10 years to implement evidence-based indications for antibiotic prescribing in Jonkoping County, Sweden. Q Manage Health Care 2007; 16: 60–7Google Scholar
  108. 109.
    Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rev 2005; (4): CD003539Google Scholar
  109. 110.
    Cals JW, Boumans D, Lardinois RJ, et al. Public beliefs on antibiotics and respiratory tract infections: an internetbased questionnaire study. Br J Gen Pract 2007; 57: 942–7PubMedCrossRefGoogle Scholar
  110. 111.
    Sahlan S, Wollny A, Brockmann S, et al. Reducing unnecessary prescriptions of antibiotics for acute cough: adaptation of a leaflet aimed at Turkish immigrants in Germany. BMC Fam Pract 2008; 9: 57 [online]. Available from URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2577089/ [Accessed 2009 Nov 20]PubMedCrossRefGoogle Scholar
  111. 112.
    Cars O, Högberg LD, Murray M, et al. Meeting the challenge of antibiotic resistance. BMJ 2008 Sep 18; 337: a1438 [online]. Available from URL: http://www.bmj.com/cgi/content/full/337/sep18_3/a1438 [Accessed 2009 Nov 20]Google Scholar
  112. 113.
    Grigoryan L, Burgerhof JG, Degener JE, et al. Determinants of self-medication with antibiotics in Europe: the impact of beliefs, country wealth and the health care system. J Antimicrob Chemother 2008; 61: 1172–9PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Catherine Sermet
    • 1
    Email author
  • Veronique Andrieu
    • 2
  • Brian Godman
    • 3
    • 4
    • 5
    Email author
  • Eric Van Ganse
    • 6
  • Alan Haycox
    • 4
  • Jean-Pierre Reynier
    • 2
  1. 1.IRDES (Institut de recherche et de documentation en économie de la santé)ParisFrance
  2. 2.Pharmacie Galénique Industrielle et CosmétologieUniversité de la MéditerranéeMarseilleFrance
  3. 3.Institute for Pharmacological Research ‘Mario Negri’MilanItaly
  4. 4.University of Liverpool Management SchoolLiverpoolUK
  5. 5.Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska InstitutetKarolinska University Hospital HuddingeStockholmSweden
  6. 6.Pharmacoepidemiology UnitCentre Hospitalier Universitaire-LyonLyonFrance

Personalised recommendations