Pharmaceutical policy analysis

Pharmaceutical policy analysis relates to evaluations and assessments of the impact of policy measures related to medicines on defined policy objectives such as affordability, sustainability, efficiency and equitable access to medicines.

Activities and deliverables

The Pharmacoeconomics Department particularly investigates the following public pharmaceutical policies: 


Pharmaceutical
policy

Research questions (selection)

Studies (selection)

Pricing policies
  • Which are the effects of changes in the pricing regulation (e.g. introduction of price control, new pricing policies) on medicine prices, availability and uptake of medicines, and equitable and affordable access to medicines, for instance?
  • Do specific pricing policies (e.g. external price referencing, value-based pricing) impact access to medicines, and its affordability for public payers and patients?
  • Which effects result from changes in the design of a pricing policy?

Gamba S, Pertile P, Vogler S (2020): The impact of managed entry agreements on pharmaceutical prices. Health Economics.

Vogler S: Evaluation of the effects of the new medicine price regulation law in Morocco (2019)
Vogler S, Schneider P, Zimmermann N (2019): Evolution of average European medicine prices: Implications for the methodology of external price referencing. PharmacoEconomics - Open 3:303–309. 
Vogler S, Gombocz M, Zimmermann N. (2017) Tendering for off-patent outpatient medicines: lessons learned from experiences in Belgium, Denmark and the Netherlands. Journal of Pharmaceutical Health Services Research 8(3): 147-158
Vogler S, Lepuschütz L, Schneider P et al. (2016): Study on enhanced cross-country coordination in the area of pharmaceutical product pricing. Funded by the Health Programme of the European Union, Vienna

Reimbursement policies
  • Which reimbursement practices can best protect vulnerable groups from excessive out-of-pocket payments on medicines?
  • Which design of co-payment regulation (e.g. fixed vs. price-related, exemptions for defined population groups) are most appropriate to ensure equitable access to medicines?
  • Which procedural rules in a reimbursement policy, including priorisation and selection criteria, ensure best to achieve intended policy objectives?

Vogler S, Dedet G, Bak Pedersen H (2019): Financial Burden of Prescribed Medicines Included in Outpatient Benefits Package Schemes: Comparative Analysis of Co-Payments for Reimbursable Medicines in European Countries. Appl Health Econ Health Policy; 803–816.

Dedet G, Polton D, Zimmermann N et al. (2019): Evaluation of the Affordable Medicines Program in Ukraine.WHO Regional Office for Europe, Copenhagen.   
Vogler S, Haasis MA, Dedet G et al. (2018): Medicines reimbursement policies in Europe. WHO Regional Office for Europe, Copenhagen
Schneider P, Vogler S (2017): Einführung eines Referenzpreissystems in der Schweiz. Analyse von Ausgestaltungsmöglichkeiten auf Einsparungspotenziale für öffentliche Zahler sowie finanzielle Belastungen für die Patienten und Patientinnen [Introduction of a reference price system in Switzerland: Analysis of different design scenarios on savings potentials for public payers and financial burden for patients]. Vienna (unpublished study)
Schneider P, Vogler S (2016): Pharmaceutical pricing and reimbursement reform in Kyrgyzstan. WHO Regional Office for Europe, Copenhagen

Measures related to pharmaceutical distribution  
  • How does deregulation of establishment and ownership rules for community pharmacies impact accessibility, efficiency and quality of pharmacy services?
  • Which incentives are linked to different designs of wholesale and pharmacy remuneration?
  • Does the liberalisation of non-prescription medicines in the community lead to lower medicine prices and higher accessibility?
Vogler S, Haasis MA, Rainer L (2018): Effects of Reforms of Regulations on Distribution Channels for Non-Prescription Medicines in Europe. Vienna (unpublished study)
Vogler S, Habimana K, Arts D (2014): Does deregulation in community pharmacy impact accessibility of medicines, quality of pharmacy services and costs? Evidence from nine European countries. Health Policy 117(3): 311-327
Vogler S, Arts D, Sandberger K (2012): Impact of pharmacy deregulation and regulation in European countries. Vienna 
 
Generic and biosimilar policies 
  • How can demand-side measures such as generic substitution and prescribing by international non-proprietary name enhance generic uptake?
  • Which savings can be generated attributable to generic and biosimilar policies?
  • Which is the most appropriate design of generic policies to generate savings for public payers while ensuring access for patients?

Vogler S, Schneider P, Panteli D et al (2019): Biosimilars in Deutschland und im europäischen Vergleich – Entwicklungen und Potenziale. [Biosimilars in Germany and in a European comparision - developments and potentials]. Schwabe U, Paffrath D, Ludwig W-D, Klauber J (ed.). Arzneiverordnungs-Report 2019. Berlin, Heidelberg: Springer; 2019. p. 321-53.

Vogler S, Zimmermann N (2013): How do regional sickness funds encourage more rational use of medicines, including the increase of generic uptake? A case study from Austria. GaBI 2(2): 65-75, 2013
Vogler S (2012): The impact of pharmaceutical pricing and reimbursement policies on generics uptake: implementation of policy options on generics in 29 European countries-an overview. GaBI Journal 1(2): 93-100
Habl C, Vogler S, Leopold C (2008): Referenzpreissysteme in Europa. Analyse und Umsetzungsvoraussetzungen für Österreich [Reference price systems in Europe. Analysis and implication for an implementation in Austria]. Vienna

Procurement policies
  • How to optimise public pharmaceutical procurement to contribute to sustainable access to medicines, to security of supply, to competition and to green manufacturing?
  • Which public procurement procedures and techniques are employed by European countries and how do they add value?
  • What are new procurement models?
Study on public procurement of medicines - ongoing: Onepager_EC_PPM_study_bf.pdf 
Cross-country collaboration
  • How can cross-country collaboration enhance access to medicines?
  • What are facilitating and challenging factors for cross-country collaborations?
  • What are key actions to be considered before establishing a cross-country collaboration?
Vogler S, Haasis MA, van den Ham R et al. (2020): Cross-country collaborations to improve access to medicines and vaccines in the WHO European Region. WHO Regional Office for Europe, Copenhagen.    
Mix of policies
  • How did cost-containment measures, e.g. undertaken in response to the financial crisis, impact prices and utilization of medicines?
  • Which is the most appropriate mix of pharmaceutical policies to ensure affordable and equitable access to medicines?
  • Can the effects of the different pharmaceutical policies be entangled with regard to different policy objectives?
  • Which measures to address shortages are effective

Vogler S, Fischer S. (2020): Lieferengpässe bei Arzneimitteln: Internationale Evidenz und Empfehlungen für Deutschland. Kurzgutachten. (in German with an English short summary, title in English: Medicine shortages: international evidence and recommendations for Germany).Gesundheit Österreich Forschungs- und Planungs GmbH, Wien.

Vogler S, Österle A, Mayer S. (2015): Inequalities in medicine use in Central Eastern Europe: an empirical investigation of socioeconomic determinants in eight countries. In: International Journal for Equity in Health, 14: 124
Leopold C, Mantel-Teeuwisse A.K, Vogler S et al. (2014): Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries. Bull World Health Organ 92:630–640D
Leopold C, Zhang F, Mantel-Teeuwisse A.K. et al. (2014): Impact of pharmaceutical policy interventions on utilization of antipsychotic medicines in Finland and Portugal in times of economic recession: interrupted time series analyses. International Journal for Equity in Health 13:53