title: Pharmaceutical policies in European countries in response to the global financial crisis.
abstract: OBJECTIVE
  The objective of this paper is to analyze which pharmaceutical policies European countries applied during the global financial crisis.
  
  
  METHODS
  We undertook a survey with officials from public authorities for pharmaceutical pricing and reimbursement of 33 European countries represented in the PPRI (Pharmaceutical Pricing and Reimbursement Information) network based on a questionnaire. The survey was launched in September 2010 and repeated in February 2011 to obtain updated information.
  
  
  RESULTS
  During the survey period from January 2010 to February 2011, 89 measures were identified in 23 of the 33 countries surveyed which were implemented to contain public medicines expenditure. Price reductions, changes in the co-payments, in the VAT rates on medicines and in the distribution margins were among the most common measures. More than a dozen countries reported measures under discussion or planned, for the remaining year 2011 and beyond. The largest number of measures were implemented in Iceland, the Baltic states (Estonia, Latvia, Lithuania), Greece, Spain and Portugal, which were hit by the crisis at different times.
  
  
  CONCLUSIONS
  Cost-containment has been an issue for high-income countries in Europe - no matter if hit by the crisis or not. In recent months, changes in pharmaceutical policies were reported from 23 European countries. Measures which can be implemented rather swiftly (e.g. price cuts, changes in co-payments and VAT rates on medicines) were among the most frequent measures. While the "crisis countries" (e.g. Baltic states, Greece, Spain) reacted with a bundle of measures, reforms in other countries (e.g. Poland, Germany) were not directly linked to the crisis, but also aimed at containing public spending. Since further reforms are under way, we recommend that the monitoring exercise is continued.
authors.affiliation: Health Economics Department, WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Gesundheit Österreich GmbH / Geschäftsbereich ÖBIG - Austrian Health Institute, Vienna, Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Vogler
authors.forename: Nina
authors.initials: N
authors.lastname: Zimmermann
authors.forename: Christine
authors.initials: C
authors.lastname: Leopold
authors.forename: Kees
authors.initials: K
authors.lastname: de Joncheere
keywords: Europe; cost-containment; global financial crisis; medicines; policy measures; pricing; reimbursement