Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries.
OBJECTIVE
To identify pharmaceutical policy changes during the economic recession in eight European countries and to determine whether policy measures resulted in lower sales of, and less expenditure on, pharmaceuticals.


METHODS
Information on pharmaceutical policy changes between 2008 and 2011 in eight European countries was obtained from publications and pharmaceutical policy databases. Data on the volume and value of the quarterly sales of products between 2006 and 2011 in the 10 highest-selling therapeutic classes in each country were obtained from a pharmaceutical market research database. We compared these indicators in economically stable countries; Austria, Estonia and Finland, to those in economically less stable countries, Greece, Ireland, Portugal, Slovakia and Spain.


RESULTS
Economically stable countries implemented two to seven policy changes each, whereas less stable countries implemented 10 to 22 each. Of the 88 policy changes identified, 33 occurred in 2010 and 40 in 2011. They involved changing out-of-pocket payments for patients in 16 cases, price mark-up schemes in 13 and price cuts in 11. Sales volumes increased moderately in all countries except Greece and Portugal, which experienced slight declines after 2009. Sales values decreased in both groups of countries, but fell more in less stable countries.


CONCLUSIONS
Less economically stable countries implemented more pharmaceutical policy changes during the recession than economically stable countries. Unexpectedly, pharmaceutical sales volumes increased in almost all countries, whereas sales values declined, especially in less stable countries.
World Health Organization (WHO) Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Gesundheit Österreich GmbH, Stubenring 6, 1010, Vienna, Austria .
Christine
C
Leopold
WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Utrecht Institute for Pharmaceutical Sciences, Utrecht, Netherlands .
Aukje K
AK
Mantel-Teeuwisse
World Health Organization (WHO) Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies, Gesundheit Österreich GmbH, Stubenring 6, 1010, Vienna, Austria .
Sabine
S
Vogler
IMS Institute for Healthcare Informatics, Philadelphia, United States of America (USA).
Silvia
S
Valkova
Department of Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland .
Kees
K
de Joncheere
WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Utrecht Institute for Pharmaceutical Sciences, Utrecht, Netherlands .
Hubert G M
HG
Leufkens
Department of Population Medicine, Harvard Medical School, Boston, USA .
Anita K
AK
Wagner
Department of Population Medicine, Harvard Medical School, Boston, USA .
Dennis
D
Ross-Degnan
Department of Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland .
Richard
R
Laing
D003132:Commerce / Q000191:economics*; D016527:Drug Costs / Q000706:statistics & numerical data*; D004335:Drug and Narcotic Control; D057172:Economic Recession; D005060:Europe; D006801:Humans