Comparing pharmaceutical pricing and reimbursement policies in Croatia to the European Union Member States

Abstract

AimTo perform a comparative analysis of the pharmaceutical pricing and reimbursement systems in Croatia and the 27 European Union (EU) Member States.MethodsKnowledge about the pharmaceutical systems in Croatia and the 27 EU Member States was acquired by literature review and primary research with stakeholders.ResultsPharmaceutical prices are controlled at all levels in Croatia, which is also the case in 21 EU Member States. Like many EU countries, Croatia also applies external price referencing, ie, compares prices with other countries. While the wholesale remuneration by a statutorily regulated linear mark-up is applied in Croatia and in several EU countries, the pharmacy compensation for dispensing reimbursable medicines in the form of a flat rate service fee in Croatia is rare among EU countries, which usually apply a linear or regressive pharmacy mark-up scheme. Like in most EU countries, the Croatian Social Insurance reimburses specific medicines at 100%, whereas patients are charged co-payments for other reimbursable medicines. Criteria for reimbursement include the medicine’s importance from the public health perspective, its therapeutic value, and relative effectiveness. In Croatia and in many EU Member States, reimbursement is based on a reference price system.ConclusionThe Croatian pharmaceutical system is similar to those in the EU Member States. Key policies, like external price referencing and reference price systems, which have increasingly been introduced in EU countries are also applied in Croatia and serve the same purpose: to ensure access to medicines while containing public pharmaceutical expenditure.

Understanding the components of pharmaceutical expenditure—overview of pharmaceutical policies influencing expenditure across European countries

“…When comparing pharmaceutical expenditure between countries, we strongly advise checking whether data are indicated net or gross. [29,30]) ask the patient to co-pay a specifi c percentage of the medicine price: specifi c medicines, whose therapeutic (added) value was assessed to be lower compared with essential or life-saving medicines, are not fully funded by the public payers, but they are reimbursed to a specifi c extent. For instance, if the pharmacy retail price is Euros 100 and the reimbursement rate is 80%, then the reimbursement price amounts to Euros 80.…”

“…Pharmacy remuneration may also be designed independently from the price, e.g. by providing a fee for service, such as in The Netherlands or in the UK [1,3,[28][29][30].…”

Politika lijekova i ugradbenih materijala u zemljama Europske unije i Republici Hrvatskoj

“…Cijena novoga istovrsnog lijeka istoga nezaštićenog imena ne smije prelaziti razinu od 90% cijene lijeka (Hrvatski zavod Unazad nekoliko godina postignut je značajan uspjeh u reformiranju politike lijekova koji je rezultirao uštedama u izdacima za lijekove. Uz praćenje i analizu izdataka za lijekove, potrebno je pratiti potrošnju lijekova, razvoj politika za po-ticanje racionalnog izdavanja lijekova, kao i bolnički farmaceutski sektor kako bi se mogao procijeniti utjecaj politike lijekova na cjelokupni sektor zdravstva (Vogler, Habl, Bogut, Vončina, 2011).…”

Medication use in European primary care patients with lower respiratory tract infection: an observational study

“…With regard to costs, the Association of the European SelfMedication Industry reported that sales of non-prescribed cough and cold products in the European Union increased from 2009 to 2011, constituting €4.8 billion in 2011. 11 Furthermore, in many European countries, health services or insurance companies pay for prescribed medication, 12 resulting in increased costs for these organisations and the societies they serve.…”