Affordability of medicines in the European Union

Zaprutko, Tomasz; Kopciuch, Dorota; Kus, Krzysztof; Merks, Piotr; Nowicka, Monika; Augustyniak, I.; Nowakowska, Elżbieta

doi:10.1371/journal.pone.0172753

Cited by 30 publications

(29 citation statements)

References 27 publications

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“…While differences in methodology (different baskets of medicines surveyed, different time lines) of the MeTA survey and this research limit comparability, both studies concluded that parts of outpatient medicines were unaffordable for the Kyrgyz population in 2015. Unaffordability of essential medicines is a barrier to access to medicines in many countries worldwide [76][77][78][79][80].…”

Section: Discussionmentioning

confidence: 99%

Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan

Vogler

Schneider

Dedet

et al. 2019

Int J Equity Health

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Background: Out-of-pocket (OOP) payments can constitute a major barrier for affordable and equitable access to essential medicines. Household surveys in Kyrgyzstan pointed to a perceived growth in OOP payments for outpatient medicines, including those covered by the benefits package scheme (the Additional Drug Package, ADP). The study aimed to explore the extent of co-payments for ADP-listed medicines and to explain the reasons for developments. Methods: A descriptive statistical analysis was performed on prices and volumes of prescribed ADP-listed medicines dispensed in pharmacies during 2013-2015 (1,041,777 prescriptions claimed, data provided by the Mandatory Health Insurance Fund). Additionally, data on the value and volume of imported medicines in 2013-2015 (obtained from the National Medicines Regulatory Agency) were analysed. Results: In 2013-2015, co-payments for medicines dispensed under the ADP grew, on average, by 22.8%. Co-payments for ADP-listed medicines amounted to around 50% of a reimbursed baseline price, but as pharmacy retail prices were not regulated, co-payments tended to be higher in practice. The increase in co-payments coincided with a reduction in the number of prescriptions dispensed (by 14%) and an increase in average amounts reimbursed per prescription in nearly all therapeutic groups (by 22%) in the study period. While the decrease in prescriptions suggests possible underuse, as patients might forego filling prescriptions due to financial restraints, the growth in average amounts reimbursed could be an indication of inefficiencies in public funding. Variation between the regions suggests regional inequity. Devaluation of the national currency was observed, and the value of imported medicines increased by nearly 20%, whereas volumes of imports remained at around the same level in 2013-2015. Thus, patients and public procurers had to pay more for the same amount of medicines. Conclusions: The findings suggest an increase in pharmacy retail prices as the major driver for higher co-payments. The national currency devaluation contributed to the price increases, and the absence of medicine price regulation aggravated the effects of the depreciation. It is recommended that Kyrgyzstan should introduce medicine price regulation and exemptions for low-income people from co-payments to ensure a more affordable and equitable access to medicines.

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Section: Discussionmentioning

confidence: 99%

Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan

Vogler

Schneider

Dedet

et al. 2019

Int J Equity Health

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“…Although it seems easy to connect the e-mail with the pharmacy's location, it was not our aim to collect and then present such data. We would not be accused of pharmacy advertising, which is strictly forbidden in Poland [5].…”

Section: Methodsmentioning

confidence: 99%

Pharmacies for the Pharmacists—Ukrainian Fears and Polish Experiences

et al. 2020

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In 2017, a regulation referred to as “pharmacies for the pharmacists” was implemented in Poland, and Ukraine is going to implement a similar act of law. The study was to collect Ukrainian pharmacists’ opinions about the upcoming market regulation and to compare their views with opinions obtained from Polish pharmacists collected two years following the amendment of this legislation. The study was conducted in Poland and Ukraine using a self-designed questionnaire. Of 2162 questionnaires received, 2043 were included in the study (1623 from Ukraine and 420 from Poland). Ukrainian pharmacists (76.8%) feared that medicine prices would increase. Moreover, they presented concerns related to poorer access to pharmaceuticals and reduced turnovers of pharmacies. Two years after the market regulation, 55.23% of Polish pharmacists pointed out that none of the fears reported in Ukraine were observed in Poland. However, 33.10% revealed that market regulation led to “a reduction in the number of pharmacies”. Ukrainian pharmacists are afraid of community pharmacies’ regulation. Polish pharmacists, however, have not observed such problems during the two years following the market regulation. The only noticeable market change in Poland was the reduced number of pharmacies.

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“…It might be easy to connect the completed questionnaire with the e-mail address of the pharmacy, but it was not our aim to collect and then to present these data. It could be considered as a pharmacy advertising which is strictly forbidden in Poland (15).…”

Section: Methodsmentioning

confidence: 99%

The Prescription to Over-the-Counter Switches and Double Registration of Medicines - The Perspective of Pharmacists From the Greater Poland.

Zaprutko¹,

Kopciuch²,

Ratajczak³

et al. 2019

Acta Poloniae Pharmaceutica - Drug Research

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The prescription to over-the-counter switch is a global occurrence. However, the switch phenomenon might be considered controversial. Nevertheless, the further development of switches seems to be inevitable, thus we collected pharmacistsí opinions about Rx-to-OTC switches including double registration of medicines. The study was conducted in pharmacies from Greater Poland, using an anonymous questionnaire, which was delivered by direct contact. Finally, answers from 232 pharmacies were included in the study. Moreover, we analyzed data from 5500 Polish pharmacies, concerning the turnover of selected and doubly registered medicines. Rx-to-OTC switches were negatively evaluated by the majority (81.5%) of respondents. ìFuraginumî was the most frequently chosen (60.8%) substance, which according to obtained answers should be available only on prescription. Study participants claimed that the most important drawback (chosen by 44.4% participants) of the double registration of medicines is the development of uncontrolled self-medication. Data obtained from a market research company revealed that the Rx-to-OTC switch may lead to the market share growth of OTC class (e.g. ìfuraginumî), but it is not the rule (e.g. ìomeprazole/pantoprazoleî). Although Rx-to-OTC switches are considered somewhat controversial, the switch, as well as double registration phenomenon, seems to be a subject of further development. However, in pharmacistsí opinion substances like ìfuraginumî should be available as an Rx-only brand instead of double registered medicine. In the case of Rxto-OTC switches, additional information about possible side effects and/or interactions should be provided to the patients who might inappropriately use medicines.

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Affordability of medicines in the European Union

Cited by 30 publications

References 27 publications

Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan

Affordable and equitable access to subsidised outpatient medicines? Analysis of co-payments under the Additional Drug Package in Kyrgyzstan

Pharmacies for the Pharmacists—Ukrainian Fears and Polish Experiences

The Prescription to Over-the-Counter Switches and Double Registration of Medicines - The Perspective of Pharmacists From the Greater Poland.

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