title: The impact of reference-pricing systems in Europe: a literature review and case studies.
abstract: As healthcare budgets are continuously rising in Europe, governments implement a wide variety of policies to control them. Reference pricing is a popular tool for governments to contain pharmaceutical expenditures, as 22 European countries have implemented this system. This article evaluates the impact of reference-pricing systems on drug use, drug prices, drug expenditure and health outcomes. In addition, two case studies, one for statins and one for proton-pump inhibitors, were carried out. Reference pricing drives down prices of drugs subject to the system and the use of these drugs has increased. Reference pricing creates short-term savings but the long-term growth of drug expenditure has not been reduced by reference pricing. Health outcomes of patients were not negatively affected by the system.
authors.affiliation: Research Centre for Pharmaceutical Care & Pharmaco-economics, KU Leuven, Belgium, Herestraat 49, O&N 2, PO Box 521, 3000 Leuven, Belgium. pieter.dylst@pharm.kuleuven.be
authors.forename: Pieter
authors.initials: P
authors.lastname: Dylst
authors.forename: Arnold
authors.initials: A
authors.lastname: Vulto
authors.forename: Steven
authors.initials: S
authors.lastname: Simoens
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000331:legislation & jurisprudence; D004363:Drug Utilization / Q000191:economics; D016568:Drugs, Generic / Q000191:economics* / Q000627:therapeutic use; D005060:Europe; D033161:Government Regulation; D005102:Health Expenditures / Q000331:legislation & jurisprudence*; D006291:Health Policy / Q000191:economics*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence; D010818:Practice Patterns, Physicians' / Q000191:economics* / Q000331:legislation & jurisprudence; D054328:Proton Pump Inhibitors / Q000191:economics* / Q000627:therapeutic use; D013810:Therapeutic Equivalency; D016896:Treatment Outcome
chemical_list: D016568:Drugs, Generic; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D054328:Proton Pump Inhibitors