Abstract
This article analyses the likely implications for the European pharmaceutical market of 2 European Court rulings (Kohll and Decker) and addresses whether these will contribute to the completion of the single European market. In doing so, the Kohll and Decker cases are discussed and the likely implications of these cases for key stakeholders (patients, providers, payers and the industry) are investigated. Of the 2 cases, the latter has direct application to pharmaceuticals as tradable goods. The article argues that the short term implications for the stakeholders, relating to the freedom of providing goods, may lead to a re-thinking of how pharmaceutical products are financed and provided in European Union (EU) countries in the long term. A key corollary of the Decker case is that it leads to greater transparency and awareness of pharmaceutical price differentials across the member states. As part of this transparency, consumers may benefit directly by gaining access to a product that may not be available in their country of residence, or may be available but at a higher cost. Consumers may also benefit indirectly through greater transparency and efficiency in the long term. Providers may wish to increase their procurement from cheaper sources of the same product and much will depend on their future procurement strategies. Manufacturers will in this case face an increase in parallel trade streams and may respond by not marketing or producing in ‘low-price’ countries. The rulings add a further supranational dimension to a national policy issue and may have far reaching implications for the EU pharmaceutical market and industry.
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References
Kanavos P, Mossialos E. Outstanding regulatory aspects in the European pharmaceutical market. Pharmacoeconomics 1999; 15 (6): 519–33
Hermans H. Legal implications of cross-border health care in the European Union [editorial]. J Health Serv Res Policy 1999; 4 (2): 61–2
Consolidated version of regulation (EEU) no. 1408/71 of the Council of 14 June 1971 on the application of social security schemes to employed persons, to self-employed persons and to members of their families moving within the Community. Official Journal of the European Communities, 35, C325, 10 December 1992
Consolidated version of Council Regulation (EEU) no. 574/72 of 21 March 1972 laying down the procedure for implementing regulation 1408/71 on the application of social security schemes to employed persons and to members of their families moving within the Community. Official Journal of the European Communities, 35, C325, 10 December 1992
Hermesse J, Lewalle H, Palm W. Patient mobility within the European Union. Eur J Public Health 1997; 7 (3 Suppl.): 4–10
Court of Justice of the EC, Case 131/85, GuelvsRegierungspraesident Duesseldorf [1986], ECR 1573, para. 17
Court of Justice of the EC, Case C-381/93, CommissionvsFrance [1994], ECR I-5145, para. 17
Court of Justice of the EC, Case C-398/95, SETTGvsYpourgos Ergasias [1997], ECR I-3091, para. 23
European Court of Justice, Case 215/87, [Heinz SchumachervsHauptzollamt Frankfurt am Main]. 1989
Court of Justice of the European Communities, Case C-120/95, Nicolas DeckervsCaisse de Maladie des Employes Prives, provisional translation from the Italian, Luxembourg, 15 September 1997
Court of Justice of the European Communities, Case C-158/96, Raymond KohllvsUnion des Caisses deMaladie, provisional translation from the Italian, Luxembourg, 15 September 1997
European Court of Justice, Judgement of the Court, Case C-120/95 [Nicolas DeckervsCaisse de Maladie des Employes Prives], and Case C-158/96 [Raymond KohllvsUnion des Caisses de Maladie], 28 April 1998
Council Regulation (EEU) No. 1408/71, of 14 June 1971 and Council Regulation (EEU) No. 574/72 of 21 March 1972
European Court of Justice, BSM Geraets-SmitsvsStichting Ziekenfonds and HTM PeerboomsvsStichting CZGroep Zorgverzekeringen; Case C-157/99; conclusions presented by the advocate general on 18 May 2000, Luxembourg
Kanavos P, McKee M, Richards T. Cross border health care in Europe: European court rulings have made governments worried [editorial]. BMJ 1999; 318 (7192): 1157–8
Kanavos P. Pharmaceutical pricing and reimbursement in Europe — 1999. Scrip reports. Richmond, Surrey: PJB Publications, 1999 Aug
Kanavos P. Single European currency and monetary union: macroeconomic implications for pharmaceutical spending. Pharmacoeconomics 1998; 13 (1 Pt 1): 9–20
Anonymous. Prescriptions valid throughout the EC says EC Commissioner. Pharm J 1993 May 8; 628
Kanavos P, coordinator. European pharmaceutical research, development and innovation: assessment of the socioeconomic impact of new drugs. IPTS working document. Seville: Institute for Prospective Technological Studies (IPTS), 1997 Apr
Thatcher M. The development of European regulatory frameworks: the expansion of European Community policy-making in telecommunications. In: Stavridis S, Mossialos E, Morgan R, et al., editors. New challenges to the European Union: policies and policy-making. Dartmouth: Aldershot, 1997
Kanavos P. The impact of the internet on health care goods and services. Scrip reports. Richmond, Surrey: PJB Publications, 2000 Oct
European Court of Justice, Case 72/83, Campus OilvsMinister for Industry and Energy [1984], ECR2727, paras 33–36. Quoted in: Hermans H. Legal implications of cross-border health care in the European Union. J Health Serv Res Policy 1999 Apr; 4 (2): 61–2
Arrow K. Uncertainty and the welfare economics of medical care. Am Econ Rev 1963; 53 (6): 941–73
Starmans B, Leidl R, Rhodes G. A comparative study on cross-border hospital care in the EuregioMeuse-Rhine. Eur J Public Health 1997; 7 (3 Suppl.): 33–41
Kanavos P. Pricing and reimbursement of pharmaceuticals in Europe. Scrip reports. Richmond, Surrey: PJB Publications, 1999 Aug: 215–29
Kanavos P. Pricing and reimbursement of pharmaceuticals in Europe. Scrip reports. Richmond, Surrey: PJB Publications, 1999 Aug: 79–100
Kanavos P. Pricing and reimbursement of pharmaceuticals in Europe. Scrip reports. Richmond, Surrey: PJB Publications, 1999 Aug: 79–100
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The author would like to thank Ann Jacklin, Chief Pharmacist at Hammersmith Hospital NHS Trust for commenting on the UK hospital drug procurement system, and 3 anonymous referees for providing helpful suggestions on an earlier version of the paper.
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Kanavos, P. The Single Market for Pharmaceuticals in the European Union in Light of European Court of Justice Rulings. Pharmacoeconomics 18, 523–532 (2000). https://doi.org/10.2165/00019053-200018060-00001
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DOI: https://doi.org/10.2165/00019053-200018060-00001