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- Title
Patient access to pharmaceuticals: an international comparison.
- Authors
Cohen, Joshua; Faden, Laura; Predaris, Susan; Young, Brian
- Abstract
We have identified eight sub-dimensions of patient access to pharmaceuticals: marketing approvals, time of marketing approval, coverage, cost sharing, conditions of reimbursement, speed from marketing approval to reimbursement, extent to which beneficiaries control choice of their drug benefit, and evenness of the availability of drugs to the population. For a sample of commonly used best-selling drugs in the United States (US), we measured these eight access sub-dimensions across four health systems: France, the Netherlands, the United Kingdom (UK), and the US. Although the US approved between 15 and 18% more drugs than the other three countries, the US was slower than France and the UK to approve drugs licensed in all four countries. The percentage of drugs covered is approximately the same for all four countries. For covered drugs, we observe the least cost sharing by patients in the Netherlands. The Netherlands imposes conditions of reimbursement on a much larger percentage of drugs. France seems to be the slowest in respect of speed from marketing approval to reimbursement. The US is the most flexible in terms of the extent to which beneficiaries control their choice of drug benefit but it is the least universal in terms of evenness of the availability of drugs to the population. Our study confirms the frequently cited problems of access in European countries: lag between marketing approval and reimbursement, and inflexibility in respect of the extent to which beneficiaries control their choice of drug benefit. At the same time, our study confirms, qualitatively, different kinds of access problems in the US: relatively high patient cost sharing for pharmaceuticals, and wide variation in coverage.
- Subjects
UNITED States; FRANCE; NETHERLANDS; DRUGS; PATIENTS; BENEFICIARIES; MARKETING; PUBLIC health; INSURANCE statistics; DRUG approval laws; COMPARATIVE studies; HEALTH services accessibility; PHARMACEUTICAL services insurance; INTERNATIONAL relations; RESEARCH methodology; MEDICAL care costs; MEDICAL cooperation; MEDICAL prescriptions; REFERENCE books; RESEARCH; TIME; PATIENT participation; HEALTH insurance reimbursement; DRUG approval; EVALUATION research; ECONOMICS
- Publication
European Journal of Health Economics, 2007, Vol 8, Issue 3, p253
- ISSN
1618-7598
- Publication type
journal article
- DOI
10.1007/s10198-006-0028-z