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Selected articles, posters and reports by Euripid members
1. Selected articles, posters and reports based on EURIPID data and information.
23rd National Report on the Use of Medicines in Italy
© Italian Medicines Agency (AIFA)
The Italian Medicines Agency (AIFA) has published the 23rd National Report on the Use of Medicines in Italy.
The Report analyses pharmaceutical use and spending data in Italy in 2022 by using the various information flows available, which allow to obtain a comprehensive picture of pharmaceutical care in the outpatient and hospital settings, both when costs are borne by the National Health Service (NHS) and when they are borne by citizens through private purchases. It provides an overview on medication use by class age and gender and insights on special populations, in particular paediatric patients and the elderly. The spending and consumption data were provided by the different ATC levels and by therapeutic category, at National Level and by Italian Regions.
The Report also includes main figures on AIFA Monitoring Registries, together with the financial impact resulting from the implementation of Managed Entry Agreements.
In the chapter on international comparison, time trends in spending and consumption of different therapeutic categories in 9 European countries over the past 4 years were studied. The price comparison analysis was further deepened by disaggregating drugs by patent coverage, and evaluating the different therapeutic categories and reimbursability classes.
Given the importance of new therapeutic entities, both in terms of expected benefits and in terms of expenditure governance, a specific section on expenditure trends was provided to monitor the impact on NHS pharmaceutical spending of new therapeutic entities. Moreover, a specific section has been dedicated to the expenditure analysis of orphan drugs.
Finally, given the recognized importance of environmental issues, a new section has been introduced in order to analyse the potential environmental impact of a number of active substances with high use or high risk of environmental toxicity. The main objective of this section is to provide an overview in order to inform and raise awareness among the public, and health care professionals, of the emerging issue on the impact that drugs have on the environment.
The English version of the Report is available here.
Exploring the feasibility of monitorin access to novel medicines: A pilot study in EU Member States
Chapman, Suzannah; Szklanowska, Anna; Lopert, Ruth; (2023)
OECD undertook a pilot study in selected EU Member States that aimed to determine the Utility and feasibility of routine cross-country monitoring of access to medicines across multiple dimensions.
This is one of the first results of the cooperation between Euripid and OECD that commenced in 2021.
A price comparison of Infliximab across European Country
Fischer, Stefan; Schneider, Peter; Habl, Claudia; Heindl, Bettina; (2023)
This is a poster of the price comparison of Infliximab accross countries in Europe.
EU wide added value of EURIPID
Habl, Claudia; Nagel, Anna; (2022)
This is a presentation of the most important achievments of the European-wide pharmaceutical price database since 2010 from a European perspective.
Feasibility study for the integration of medical devices into EURIPID
Windisch, Friederike; Habl, Claudia; (2022)
The EURIPID Collaboration has considered including medical devices into the database. Therefore this study analysed previous work on medical devices within EURIPID. A survey was conducted with the EURIPID collaborating partners to investigate whether or not reimbursement and price lists for medical devices exist in the countries and for which price types.
Calculation of Purchasing Power Parties for Pharmaceutical Products via EURIPID database
Habl, Claudia; Zuba, Martin; (2022)
Purchasing power parities (PPPs) are indicators of price level differences for all goods and services across countries. In a cooperation between Eurostat and EURIPID the PPP calculation was alternatively done with the EURIPID database for 28 countries.
Euripid project leaflet
Schneider, Peter (2022)
The leaflet gives an short overview about the EURIPID organisation. It lists the member countries and explains what data is included in the database. You can also find the milestones, main activities and the outlook of the future of EURIPID there.
How the Euripid collaboration contributes to price transparency of pharmaceuticals
Habl, Claudia; Fischer, Stefan; (2021)
Spending on pharmaceuticals is growing continuously with a forecast of reaching over one trillion Euro in the next five years. Also, the average price of newly launched medicines is steeply raising. To manage high launch prices, public payers in Europe more and more rely on private law contractual arrangements with pharmaceutical companies, requiring significant price discounts and other types of managed-entry agreements (MEAs).
In spring 2021 we analysed the EURIPID database for occurrence and frequency of MEA in the 28 countries
EURIPID contribution to the online public consultation on the Pharmaceutical strategy for Europe
Executive Committee (2020)
There are calls for more transparency of pharmaceutical pricing by the European Parliament, the WHA, OECD, national governments and stakeholders.
The EURIPID Collaboration Executive Committee makes some statements and proposes principles that should be considered.
How the Euripid Collaboration contributes to the affordability of medicines in Europe
Claudia Habl, Gergely Nemeth, Peter Schneider
Poster presented on the 12th European Public Health Conference 2019, 20. – 23. November, Marseille
How the Euripid Collaboration contributes to the affordability of medicines in Europe.
Claudia Habl, Gergely Nemeth, Peter Schneider
Presentation on the 4th International PPRI conference 2019: Medicine access challenge – The value of pricing and reimbursement policies, 2019 24th October, Vienna
Publishe in Journal of Pharmaceutical Policy and Practice 2019, 12(Suppl 3): P16
Read more on page 21
Ex-post analysis of medicines subject to Managed-Entry-Agreements (MEAs) – a feasible approach for monitoring and price analyses.
Claudia Habl, Gergely Nemeth, Peter Schneider
Presentation on the 4th International PPRI conference 2019: Medicine access challenge – The value of pricing and reimbursement policies, 2019 24th October, Vienna
Publishe in Journal of Pharmaceutical Policy and Practice 2019, 12(Suppl 3): P21
Read more on page 24
Price comparison of high-cost pharmaceuticals 2017 (German only)
Peter Schneider, Sabine Vogler, Nina Zimmermann, Martin Zuba (Gesundheit Österreich, GÖG)
Continuous monitoring and analysis of medicine prices support policy-makers in strengthening and further developing pharmaceutical pricing policies. High-cost medicines, i.e. those medicines that account for high public pharmaceutical expenditure, are of particular interest for policy-makers. Against this backdrop, the study aims to analyse Austrian prices of high-cost medicines in comparison to other European Union (EU) Member States.
Implication of External Price Referencing on Pharmaceutical list prices in Europe
Csanadi M, Prins CPJ, Grélinger E, Fricke FU, Fuksa L, Tesar T, Manova M, Lorenzovici L, Kiss A, Kaló Z
External price referencing (EPR) is a frequently applied cost-containment measure to control pharmaceutical prices. This study aims to determine the implications of EPR on ex-factory pharmaceutical prices in European countries.
Poster was presented at the 19th ISPOR Annual European Congress, Vienna, 29 Oct -2 Nov 2016
What happens to originator medicines when (generic) followers enter the public market
Claudia Habl, (Gesundheit Österreich GmbH,GÖG), Christine Leopold (Harvard Medical School & Harvard Pilgrim Healthcare Institute)
Many pharmaceutical companies claim that because of European national pricing regulations, namely the wide-spread policy of external reference pricing some off-patent originator products disappeared from the public market. We investigated likelihood and timelines for occurrence.
The poster was presented at the 19th ISPOR Annual European Congress, Vienna, 29 Oct -2 Nov 2016
How to do External Reference Pricing by avoiding negative impact for patient access to medicines
Claudia Habl, Peter Schneider (Gesundheit Österreich GmbH, GÖG)
With the growing use of External Reference Pricing (ERP) – a policy to compare the prices of medicines in a country with those in other countries – some stakeholders in the field of public health claimed that this policy has negative effects on the affordability and accessibility of medicines to patients in Europe. One claimed reason was, for instance the delay of product launches in some countries. National competent authorities in charge of medicines pricing and reimbursement (P+R authorities) took these claims seriously and promised to investigate the issue.
Presented at the 9th European Public Health Conference, Vienna 11 Nov 2016, published in the European Journal of Public Health, Vol. 26, Supplement 1, 2016 (page 3f.)
Development of pharmaceutical prices in the Former Yugoslavian Republic of Macedonia (FYRM) in comparison to selected countries outside the national reference baskets
Claudia Habl, (Gesundheit Österreich GmbH, GÖG), Kristina Hristova, (Health Insurance Fund, of the Former Yugoslavian Republic of Macedonia (HIF)
Budgetary constraints – with annual growth rates that peaked at 20% – fuelled by the upcoming economic crisis demanded a change in the pricing model for pharmaceuticals in the Republic of Macedonia. Several neighbouring countries were faced with similar challenges, so the Republic of Macedonia carefully looked into their policies and thus introduced external reference pricing in 2011, which led to a reduction of prices. The specific was that both the Ministry of Health for the “unique price” (i.e. the maximum price) and the Health Insurance Fund as a basis for reimbursement performed price comparisons. The country basket for the Ministry of Health includes Bulgaria, Croatia, France, Germany, Greece, the Netherlands, Poland, Russia, Serbia, Slovenia, Turkey and the UK whereas the HIF references Bulgaria, Croatia, Serbia and Slovenia. The aim of the study was to show the trend of price reductions achieved for selected pharmaceuticals in the Republic of Macedonia as compared with the non-basket countries Hungary, Czech Republic and Austria.
Poster presented at PPRI Conference, Vienna, 12-13 October, 2015
Price comparison of high-cost medicines 2015 among European Union Member States
Sabine Vogler, Peter Schneider, Nina Zimmermann (Gesundheit Österreich, GÖG)
The aim of the study was to analyse and compare prices of high-cost medicines among European Union Member States. Medicines that account for a high share of public pharmaceutical expenditure were defined as high-cost medicines.
2. Selected analyses and reports conducted by EURIPID participants.
Medicine price transparency and confidential managed-entry agreements in Europe: findings from the EURIPID survey
Russo, Pierluigi; Carletto, Angelica; Németh, Gergely; Habl, Claudia (2021)
Pricing of pharmaceuticals is an all-time challenge for healthcare systems. Often public payers agree with companies on confidential managed-entry agreements (MEAs) that, e.g. foresee discounts under specific circumstances. The EURIPID Executive Committee surveyed 22 European countries, who all reported the use of confidential agreements between pharmaceutical companies and public payers, confirming that the actual prices paid are typically lower than the published list price. In 68% of the countries, the confidentiality of MEAs is required by non-disclosure clauses between companies and public payers. In some countries (27%) this is even backed up by a specific law. Our study identified legal constraints for the sharing of information on actual prices and confidential agreements among European countries and consequently restrictions in transparency. In conclusion, the EURIPID survey findings suggest that the current possibility to improve the medicines’ price transparency across countries is limited and the issue probably requires international institutional engagement, at least to coordinate initiatives toward a greater collaboration among member states.
The implications of external price referencing on pharmaceutical list prices in Europe
Marcell Csanádi, Zoltán Kaló, Christian P.J.Prins, Ezter Grélinger, Anna Menczelné Kiss, Frank-Ulrich Fricke, Leoš Fuksa, Tomas Tesar, Manoela Manova, László Lorenzovici, Zoltán Vokó, Louis P. Garrison
External price referencing (EPR) is a frequently applied cost-containment measure to control pharmaceutical prices. This study aims to determine the implications of EPR on ex-factory pharmaceutical prices in European countries.
Prices of 21 pharmaceuticals and 17 non-pharmaceutical services were collected with a survey and price corridors were defined in 7 countries. To increase the sample size for further analysis, pharmaceutical prices were retrieved from EURIPID database for 8 additional countries. Regression analyses were applied to evaluate explanatory variables on pharmaceutical list prices including EPR components, GDP per capita, and population size in 15 European countries.
Price corridor was narrower for pharmaceuticals compared to non-pharmaceutical services. In univariate regression analysis, higher GDP per capita and population size were associated with higher prices, and taking lowest price from referenced basket of countries was associated with lower prices. In multiple regression analysis, GDP per capita, population size and number of countries referencing a country had modest, but significant association with prices.
Findings indicate small price variation for pharmaceuticals that points towards the occurrence of price-convergence. The relatively minor association of EPR with pharmaceutical list prices could be explained by manufacturers’ compensatory mechanisms including confidential price reductions and discounts while maintaining high list prices in countries with strong price-control measures or delayed product launch in countries with traditionally lower prices. Consequently, EPR cannot be directly associated with narrow European price corridor, and lower income countries still have slightly lower list prices.
What happens to originator medicines when (generic) followers enter the public market
Claudia Habl (Gesundheit Österreich GmbH, GÖG), Christine Leopold (Harvard Medical School & Harvard Pilgrim Healthcare Institute, Boston, USA)
The poster was presented at the 19th ISPOR Annual European Congress, 29 Oct -2 Nov 2016, Vienna.
Development of pharmaceutical prices in the Former Yugoslavian Republic of Macedonia (FYRM) in comparison to selected countries outside the national reference baskets
Claudia Habl (Gesundheit Österreich GmbH, GÖG), Kristina Hristova (Health Insurance Fund, HIF of the Former Yugoslavian Republic of Macedonia)
Poster presented at PPRI Conference, Vienna, 12-13 October, 2015
Implication of External Price Referencing on Pharmaceutical list prices in Europe
Csanadi M, Prins CPJ, Grélinger E, Fricke FU, Fuksa L, Tesar T, Manova M, Lorenzovici L, Kiss A, Kaló Z
The poster was presented at the 19th ISPOR Annual European Congress, 29 Oct -2 Nov 2016, Vienna.
How to do External Reference Pricing by avoiding negative impact for patient access to medicines
Claudia Habl, Peter Schneider Gesundheit( Österreich GmbH, GÖG)
Presented at the 9th European Public Health Conference in Vienna on 11 November 2016, published in the European Journal of Public Health, Vol. 26, Supplement 1, 2016 (page 3f.)
Rational use of pharmaceuticals – Comparative analysis of the structure of pharmaceutical therapy of diabetes between Hungary and Denmark 2010-2012
Katalin Bögöly, Gergely Németh, Nóra Nádudvari, National Health Insurance Fund Administration (OEP)
The three-part article series on diabetes, asthma and osteoporosis intends to perform a comparative analysis of the structure of pharmaceutical therapies in Hungary and Denmark. The aim of the analysis to determine the differences in the structure of drug utilisation and the results in treatment between the two countries. It is an important question whether drug spending is done in an efficient way or not, in other words did the expenditures achieved therapeutic objectives at the level of the population.
Reports in the field of price comparison from other data sources
International price comparison 2021 – An analysis of Swedish pharmaceutical prices and volumes relative to 19 other European countries
David Sjöberg, Oskar Johansson, Daniel Högberg and Per Hortlund (Tandvårds- och läkemedelsförmånsverket, TLV)
This report is part of TLV’s mandate to analyse developments in the Swedish pharmaceutical market from an international perspective. The report is the eight annual report of its kind. The report compares Swedish pharmaceutical prices with prices in 19 other European countries. List prices (pharmacy’s wholesale prices, AIP) were used, meaning that any agreements on discounts on pharmaceuticals in different countries were not taken into account in the analyses. The focus of the report has been prescription pharmaceuticals. A division has also been made based on the competitive situation for a pharmaceutical, as the conditions vary greatly depending on whether there is generic competition.
International price comparison 2020 – An analysis of Swedish pharmaceutical prices and volumes relative to 19 other European countries
David Sjöberg, Oskar Johansson, Daniel Högberg and Per Hortlund (Tandvårds- och läkemedelsförmånsverket, TLV)
This report is part of TLV’s mandate to analyse developments in the Swedish pharmaceutical market from an international perspective. The report is the seventh annual report of its kind. The report analyses Swedish prices over the pharmaceutical life cycle. The analysis compares the price level of pharmaceuticals used in Swedish outpatient care with 19 other European countries. The analysis is based on national pharmacy wholesale list prices. In several countries, there are agreements on discounts or repayments, meaning that the net cost of pharmaceuticals will ultimately be lower than the cost based on officially determined list prices.
International price comparison 2019 – An analysis of Swedish pharmaceutical prices and volumes relative to 19 other European countries
David Sjöberg, Oskar Johansson, Ulrika Grundström, Sara Dalin (Tandvårds- och läkemedelsförmånsverket, TLV)
The Dental and Pharmaceutical Benefits Agency, hereafter TLV, has a mandate to monitor and analyse the developments in the pharmaceutical, pharmacy and dental care markets in Sweden. One of TLV’s tasks is to develop value-based pricing in order to ensure that the cost of pharmaceuticals is reasonable throughout the entire life cycle. Part of this work involves setting Sweden’s pharmaceutical prices and use in an international perspective. The regulation (2007:1206) with instructions to TLV, amongst other things, states that the agency has a mandate to monitor and analyse developments in other countries and take advantage of experiences, compare the price level in Sweden with prices in other countries for relevant products, and also monitor price developments in an international perspective. This report is part of the ongoing work and is the sixth report of its kind.
The comparison covers pharmaceuticals not exposed to competition as well as pharmaceuticals exposed to competition. The report describes how the prices of prescription pharmaceuticals in Sweden relate to 19 other countries in Europe.
The purpose of the report is to analyse the Swedish prices in an international perspective. In addition, the dynamics are examined in terms of price, volume and exchange rate, factors that affect the Swedish prices in relation to other countries.
International price comparison 2018 – An analysis of Swedish pharmaceutical prices and volumes relative to 19 other European countries
David Sjöberg, Andreas Ulden, Per Hortlund, Joakim Karlsson, and Niclas Stridsberg, amongst others (Tandvårds- och läkemedelsförmånsverket, TLV)
The Dental and Pharmaceutical Benefits Agency’s (TLV’s) mandate includes monitoring and analysing the price development of pharmaceuticals from an international perspective. In this report, TLV presents the results of the analysis of price and volume data for the first quarter of 2014, 2015, 2016, 2017 and 2018 in Sweden in comparison with 19 other European countries. The segments analysed are pharmaceuticals not exposed to competition and pharmaceuticals exposed to competition, with the latter including all pharmaceuticals available as substitutable medicines in the Swedish generic substitution system (product-of-the-month) as per March.
The report should be viewed as a basis for further analysis of the dynamics of Swedish prices and price changes compared to that seen internationally.
International price comparison of pharmaceuticals 2017 – A volume based analysis of Swedish pharmaceutical prices relative to 19 other European countries.
Emil Aho, Pontus Johansson, Gunilla Rönnholm (Tandvårds- och läkemedelsförmånsverket, TLV)
In this report, TLV presents the results of the analysis of price and volume data for the first quarter of 2014, 2015, 2016 and 2017 in Sweden in comparison with 19 other European countries. The segments analysed are pharmaceuticals not exposed to competition and pharmaceuticals exposed to competition, with the latter including all pharmaceuticals available as substitutable medicines in the product-of-themonth system as per March 2017.
The report should be viewed as a basis for further analysis of the dynamics of Swedish prices and price changes compared to that seen internationally.
International price comparison of pharmaceuticals 2016 – A volume based analysis of Swedish pharmaceutical prices relative to 19 other European countries.
Emil Aho, Pontus Johansson, Gunilla Rönnholm (Tandvårds- och läkemedelsförmånsverket, TLV)
The international price comparison report is part of TLV’s assignment to monitor developments in the Swedish pharmaceutical market from an international perspective. It is the third report of its kind.
The analysis is based on national list prices at pharmacy purchase price level.
The analysis compares the price levels of pharmaceuticals used in Swedish outpatient care with 19 other European countries: Belgium, Denmark, Finland, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Switzerland, Slovakia, Spain, Great Britain, the Czech Republic, Germany, Hungary and Austria.
The pharmaceuticals have been divided into segments based on the prerequisite for competition in Sweden; pharmaceuticals not exposed to competition and those exposed to competition, which includes all pharmaceuticals included as substitutes for the product-of-the-month in March 2016. Pharmaceutical data have been grouped according to substance, dosage form and strength.
Deliverables within the EURIPID platform
Feasibility study for the integraton of medical devices into EURIPID
Friederike Windisch (Gesundheit Österreich GmbH, GÖG), Claudia Habl (Gesundheit Österreich GmbH, GÖG)
This feasibility study was prepared by Gesundheit Österreich GmbH (Austrian National Public Health Institute) and funded by the European Union’s Health Programme (2014-2020).
Technical guidance document on External Reference Pricing
Claudia Habl (Gesundheit Österreich GmbH, GÖG), Peter Schneider (Gesundheit Österreich GmbH, GÖG), Gergely Németh (National Health Insurance Fund Administration, OEP), Robin Sebesta (State Institute for Drug Control, SUKL)
The EURIPID Collaboration prepared and published this document. The report was produced under the third Health Programme (2014-2020).
