Pricing and reimbursement are two major pharmaceutical policy areas. In the European Union (EU), Member States are free to decide on how to design and optimize their pharmaceutical pricing and reimbursement systems provided that they comply with the provisions of the EU Transparency Directive (e.g. time-lines, transparent decision processes, publication). Policy-makers have a range of policy options for pricing and reimbursement: statutory pricing vs. free pricing, distribution margins, taxes like value added tax on medicines, procedures like external price referencing or internal price referencing, health economics and HTA as decision-supporting tools, different reimbursement eligibility schemes, reimbursement lists (positive list / negative list), reference price systems. In the light of the market entry of new, expensive medicines, managed entry agreements are increasingly used, and horizon scanning will play a more important role.
European countries are constantly working on refining their pharmaceutical pricing and reimbursement systems; as a result, there are 28 different pharmaceutical pricing and reimbursement systems in the European Union.
The pharmaceutical pricing and reimbursement system in a country refers to the policy framework for the out-patient sector as well as for the hospital sector (see below).
The WHO Collaborating Centre draws much of this country knowledge from the PPRI network members (country representatives, mainly from public authorities for pharmaceutical pricing and reimbursement) who wrote country reports and have been regularly providing information and data which the Centre staff has used for cross-country studies, for the WHO CC database and presentations. Country specific as well as comparative information is provided in the P+R (pricing & reimbursement) database of our WHO CC.