The New and Old Europe: East-West Split in Pharmaceutical Spending

Abstract

HIGHLIGHTS Since the geopolitical developments of 1989, former centrally planned economies of Eastern Europe followed distinctively different pathways in national pharmaceutical expenditure evolution as compared to their free market Western European counterparts.Long term spending on pharmaceuticals expressed as percentage of total health expenditure was falling in free market economies as of 1989. Back in early 1990s it was at higher levels in transitional Eastern European countries and actually continued to grow further.Public financing share of total pharmaceutical expenditure was steadily falling in most Central and Eastern European countries over the recent few decades. Opposed scenario were EU-15 countries which successfully increased their public funding of prescription medicines for the sake of their citizens.Pace of annual increase in per capita spending on medicines in PPP terms, was at least 20% faster in Eastern Europe compared to their Western counterparts. During the same years, CEE region was expanding their pharmaceuticals share of health spending in eight fold faster annual rate compared to the EU 15.Private and out-of-pocket expenditure became dominant in former socialist countries. Affordability issues coupled with growing income inequality in transitional economies will present a serious challenge to equitable provision and sustainable financing of pharmaceuticals in the long run.

The perverse impact of external reference pricing (ERP): a comparison of orphan drugs affordability in 12 European countries. A call for policy change

“…Various studies in the literature have investigated the relevant issue of inequitable access to drugs between high GDP and low GDP countries in Europe [22–24]. Of note, these studies assessed innovative medicines that are able to offer patients better outcomes.…”

“…The lower GDP countries Poland, Bulgaria, Romania, and Hungary showed higher relative costs than high GDP countries by only a factor of around two compared to three to six times when GDP per capita was used (Figure 2). This could be attributed to the 20% faster pace of annual increase in per capita spending on medicines in eastern Europe compared to western Europe [24]. In the past four decades, the central and eastern European countries increased their annual rate of spending on pharmaceuticals eight times faster than the EU-15 [24].…”

“…This could be attributed to the 20% faster pace of annual increase in per capita spending on medicines in eastern Europe compared to western Europe [24]. In the past four decades, the central and eastern European countries increased their annual rate of spending on pharmaceuticals eight times faster than the EU-15 [24]. However, this does not directly translate to the citizen’s ability to purchase high-cost medicines in these countries.…”

“…However, this does not directly translate to the citizen’s ability to purchase high-cost medicines in these countries. Drug spending was and is mostly from private funds and out-of-pocket expenditure is highly predominant [24]. With minimal public funding support, affordability issues still ensue.…”

Economic Evaluation of Pharmacogenetic Tests in Patients Subjected to Renal Transplantation: A Review of Literature

“…Among the few bright success stories in lessening the grip of major NCDs are certainly the BRICS nations (89). Such change of morbidity has clearly reflected on the demand for pharmaceuticals and national spending on medicines in a large number of countries (90, 91). In case of immunosuppressants used in renal transplantation procedures, this growth was significant both in prescription and value-based terms (92).…”