The choice of medicines needed for treatment in hospitals has a considerable impact on the medicines supplied for the patients after their discharge. However, knowledge about medicines management in hospitals was rather poor for a long time since analyses of pharmaceutical policies and surveys of pharmaceutical systems usually focus on the out-patient sector.
The 2010 PHIS Hospital Pharma Report provides an overview of the in-patient pharmaceutical system in 27 European countries, based on country hospital pharma reports, and case studies for five selected countries, including a price survey. The price survey provided evidence about the importance of discounts and rebates in the hospital setting: for medicines where therapeutic alternatives exist, actual hospital prices might be considerably lower than the official list prices, while discounts are less likely to be provided where there is only an on-patent product available.
Another key finding of our work on Hospital Pharma was that an urgent need for a better coordination between the out-patient and in-patient sector ()interface management) was expressed by several country officials and stakeholders, while there are few good practice examples.
The WHO Collaborating Centre continues working on these issues. The PPRI Conference 2011 had one strand devoted to “Pharma Hospital and Interface management”, offering a good deal of insight on challenges, tools and good practice examples. Interface issues are again a topic adressed at the PPRI Conference 2015. The Vienna WHO Collaborating Centre was also involved in the course on interface management in Stockholm in September 2012, which was a follow-up activity of the 2011 Vienna PPRI Conference related to interface management. Studies about the medicines management and discounted prices in hospitals were published (for instance, articles about the role of discounts and loss leaders in Austrian hospitals, about the extent of discounts in hospitals and the availability of generics in hospitals as well as posters on terminology related to and activities to enhance interface management).
Based on our experience about the importance of the in-patient medicines sector, we have been considering Hospital Pharma as an important aspect in the development and refinement of our methodological tools: The glossary contains in-patient relevant terms; the set of indicators and the database comprise hospital indicators; and we have developed reporting system instruments (templates) for providing country information about the hospital medicines sector both for surveying the out-patient and in-patient pharmaceutical sectors in an integrative approach. While these tools were developed in the European context, they may serve as a model for countries world-wide.