HistoriquePolitiqueMedicament

www.irdes.fr Juin 2013
La politique du médicament en France
system level factors: Differences in reimbursement policies, and the role of health technology
assessment, were highlighted as a likely driving force of international variation in almost all
areas of medicines use reviewed. A related aspect is patient co-payment, which is likely to
play an important role in the United States in particular. The extent to which cost-sharing
policies impact on overall use of medicines in international comparison remains unclear. (2)
Service organisation and delivery: Differences in access to specialists are a likely driver of
international variation in areas such as atypical anti-psychotics, dementia, and rheumatic
arthritis, with for example access to and availability of relevant specialists identified as acting
as a crucial bottleneck for accessing treatment for dementia and rheumatoid arthritis. (3)
Clinical practice: Studies highlighted the role of variation in the use and ascertainment
methods for mental disorders; differences in the use of clinical or practice guidelines;
differences in prescribing patterns; and reluctance among clinicians in some countries to take
up newer medicines. Each of these factors is likely to play a role in explaining international
variation in medicines use, but their relative importance will vary depending on the disease
area in question and the system context
http://www.rand.org/pubs/technical_reports/2010/RAND_TR830.pdf
Puig-Junoy J. (2010). Impact of European pharmaceutical price regulation on generic price
competition. A review. Pharmacoeconomics, 1-15.
Timur A., Picone G., Desimone J.S. (2010). Has the European Union Achieved a Single
Pharmaceutical Market? Cambridge : NBER
Abstract: This paper explores price differences in the European Union (EU) pharmaceut- ical
market, the EU's fifth largest industry. With the aim of enhancing quality of life along with
industry competitiveness and R&D capability, many EU directives have been adopted to
achieve a single EU-wide pharmaceut- ical market. Using annual 1994–2003 data on prices
of molecules that treat cardiovascular disease, we examine whether drug price dispersion
has indeed decreased across five EU countries. Hedonic regressions show that over time,
cross-country price differences between Germany and three of the four other EU sample
countries, France, Italy and Spain, have declined, with relative prices in all three as well as
the fourth country, UK, rising during the period. We interpret this as evidence that the EU has
come closer to achieving a single pharmaceutica- l market in response to increasing
European Commission coordination efforts
http://papers.nber.org/papers/w16261
VRIJENS (F.), VAN DE VOORDE (C.), FARFAN-PORTET (M.I.)
Belgian Health Care Knowledge Centre. (K.C.E.). Bruxelles. BEL, Centre Fédéral d'Expertise
des soins de santé. Bruxelles. BEL
Le système du prix de référence et les différences socio-économiques dans
l’utilisation des médicaments moins onéreux.
KCE report; 126B
Bruxelles : KCE
2010
Vol : N° : Numéro spécial :
Pages : 2 vol (69; 50p.), tabl., ann.
Cote Irdes : En ligne
Afin de maîtriser les dépenses publiques relatives aux médicaments sur ordonnance en
soins ambulatoires, la plupart des pays européens ont opté pour un système de prix de
référence (SPR). En Belgique, le SPR se dénomme Système de Remboursement de
Référence. Le SPR limite le remboursement des médicaments en fixant un niveau maximum
de remboursement pour un groupe de spécialités pharmaceutiques. Toute différence entre le
prix de référence et le prix d’un médicament plus onéreux doit être payée par le patient et est
appelée « supplément de référence ». Le supplément de référence est différent du ticket
modérateur, car il s’applique de manière uniforme à tous les patients (c.à.d.
indépendamment de leur éligibilité au remboursement majoré) et, de plus il peut être évité en
Pôle documentation de l’Irdes – Safon M.-O., Suhard V. avec la collaboration de Pichetti S.
http://www.irdes.fr/EspaceDoc/index.htm 124/147
http://www.irdes.fr/EspaceDoc/DossiersBiblios/HistoriquePolitiqueMedicament.pdf