PHP90 - Market Access In The Context Of Economic Crisis: Insights From Several European Countries

Abstract

Since the onset of the economic crisis in Europe (2008), several countries have been pushed to adopt policy measures to reduce pharmaceutical expenditure, inevitably affecting people’s access to medicines. Hence, this research aims to explore policy and cost-containment measures regarding access to medical treatments across Europe following the economic crisis and the implementation of austerity measures. We searched Web of Science using a strategy that combined different terms for “austerity” and “market access”. We limited our searches to European countries and to a timeframe of 8 years (January 2008 – May 2016). We supplemented our searches with a hand-search of the websites of the national Ministries of Health for each country. Titles and abstracts were assessed by one reviewer. A total of 94 citations were identified: 59 abstracts were screened and 43 met the inclusion criteria for full-text review. Finally, 13 papers were included in the review. Four categories of policy measures have been taken across Europe: rational selection and use of medicines, sustainable financing for medicines, affordability of medicines, and reliable health care and supply systems for provision of medicines. For example, measures to increase efficient allocation of pharmaceutical resources (increase in user co-payment, changing the reference pricing regulation) have been implemented in Estonia, Italy, Lithuania, and Spain. Another policy measure that has been extensively used during the economic crisis in Europe (Greece, Italy, Lithuania, Estonia, Spain, Latvia) was the promotion of prescribing and use of generic medicines together with medicines price reduction. Even though efforts have been made to ensure access to medicines across Europe since the beginning of the financial crisis (e.g. reduced co-payment for vulnerable groups, enhanced primary care services, free essential medicines), many of these policy solutions might lead to higher costs in the long run and have negative effects on people’s health.