title: The efficient use of pharmaceuticals: does Europe have any lessons for a Medicare drug benefit?
abstract: Managing drug use in a way that maximizes the value obtained from total health care spending faces obstacles; hence, payers and policymakers tend to look at pharmaceutical expenditures in isolation from the rest of health care spending. Currently there are both regulatory and putative market-based approaches to containing pharmaceutical spending worldwide. But evidence suggests that regulatory efforts in Europe and elsewhere have not proved effective in containing costs or improving efficiency or access, and supposedly market-based solutions now in vogue, such as reference pricing, pose their own set of challenges and may in practice violate market principles. In the end, silo-based budgeting is short-sighted; the emphasis in Europe and in the United States should be on measures that achieve efficient health care rather than the containment of drug spending.
authors.affiliation: Office of Health Economics, London.
authors.forename: Adrian
authors.initials: A
authors.lastname: Towse
mesh_terms: D000368:Aged; D003363:Cost Control; D017047:Cost Sharing; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics*; D017598:Efficiency, Organizational; D005060:Europe; D006302:Health Services Research; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000191:economics*; D006278:Medicare / Q000191:economics / Q000458:organization & administration; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D011050:Policy Making; D019057:Quality-Adjusted Life Years