[AF] Fwd: AW: [isdbweb] high cost Medicines

[Nuria Homedes]

DE Alemania

nuria


Dear Nuria,
 
A lot of questions! 
 
Brief answers below. If you need more details ask again.
 
Best regards
 
Jorg
 
Jörg Schaaber
Pharma-Brief
BUKO Pharma-Kampagne
August-Bebel-Str. 62
33602 Bielefeld
Germany
Phone +49-(0)521-60550
         direct -96879483
Fax +49-(0)521-63789
jschaaber en bukopharma.de
www.en.bukopharma.de 
 
Von: isdbweb en yahoogroups.com [ mailto:isdbweb en yahoogroups.com] Im Auftrag von Nuria Homedes
Gesendet: Mittwoch, 19. August 2009 04:59
An: isdbweb en yahoogroups.com
Cc: federico en federicotobar.com.ar
Betreff: [isdbweb] high cost Medicines
 
  Answers for Germany

Dear Friends,

We are looking for information on how different countries provide 
access to high cost medicines. Some of the specific questions that we 
are attempting to obtain are:

- How do countries determine the high cost medicines they will cover?

Usefullness. In principle all prescription drugs are reimbursed, but ...

There is a price cap system (Festbetrag) for drugs where comparable therapies exist. As this takes reference to the existing drugs for the indication it is of limited use if the competitor drugs are (relatively) expensive too. This system does not work if only one patented drug for the indication exists.

Lifestyle drugs are generally excluded.

- Who can access those medicines? what is the process that patients 
need to follow to access those medicines?

No special process. A new method has just been introduced for a few very expensive and risky medicines. It requires a second opinion by a specially qualified doctor before the drug can be prescribed. This is still in the making.


- How are these medicines procured? How are they distributed?

Procurement and distribution through the normal channels (private pharmacies). 


- Who pays for the medicines? Any patient co-payment?

The public health insurance.

Co-payment is 5 to 10 Euro per package depending on the price.


- How much is the country spending in high cost medicines? how much 
of the pharma budget is spent in high cost medicines?

Data only for the public sector (90% of the population - only rich people can have a private insurance)

The 30 drugs with the highest turnover cost 5034 million Euros per year (2007). That means 20.3% of the total drug budget.

- what systems does the country have to control leakage?

What do you mean by leakage? 

The pharmacy system is safe and well controlled.

Off label-use exists and is a problem though the health insurers can punish doctors who prescribe to many expensive meds.


- other...

Thank you very much for your assistance,

Federico Tobar and Nuria Homedes 
__,_._,___