유럽국가들의 약품비 총액관리제 시행과 관련된 요인 분석 및 시사점

Factors Associated with Fixed Budgets for Pharmaceuticals in European Countries

This study examines factors associated with fixed budgets for pharmaceuticals and clawback system for phar- maceutical industry in European countries. We used information from a survey held in 2005~2006 by Austrian Health Insti- tute. Several information including pharmaceutical pricing policies, marketing conditions for pharmaceutical industry and patient' choice of drugs was collected. Five out of twenty five countries in EU were considered as countries with fixed bud- gets for pharmaceuticals and remaining 20 countries were considered as countries without fixed budget system. Com- parisons were made for each information. Countries with fixed budgets for pharmaceuticals were more likely to have internal (or external) reference pricing system and other pricing mechanisms. In addition, they were more likely to permit pharmaceutical industry to be engaged in public advertising and information provision towards patients. They guaranteed patient participation in drug choice decisions. The countries with fixed budgets for pharmaceuticals were more likely to have conditions that enable the fixed budget system to work better compared to those without fixed budget system. Therefore, the study results imply that we need to check whether we have similar conditions to the countries that already have fixed budgets for pharmaceuticals when we want to introduce fixed budget mechanism for pharmaceuticals in Korea in the future.