The impact of reference-pricing systems in Europe: a literature review and case studies

Abstract

As healthcare budgets are continuously rising in Europe, governments implement a wide variety of policies to control them. Reference pricing is a popular tool for governments to contain pharmaceutical expenditures, as 22 European countries have implemented this system. This article evaluates the impact of reference-pricing systems on drug use, drug prices, drug expenditure and health outcomes. In addition, two case studies, one for statins and one for proton-pump inhibitors, were carried out. Reference pricing drives down prices of drugs subject to the system and the use of these drugs has increased. Reference pricing creates short-term savings but the long-term growth of drug expenditure has not been reduced by reference pricing. Health outcomes of patients were not negatively affected by the system.

Keywords::

• drug expenditure
• drug prices
• drug use
• generic
• health outcome
• pharmaceuticals
• PPI
• reference pricing
• reimbursement
• statins

Acknowledgements

The authors would like to thank Alan Sheppard for providing access to IMS Health data.

Financial & competing interests disclosure

Steven Simoens holds the EGA Chair ‘European policy towards generic medicines’. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.