source: http://www.oecd.org/dataoecd/46/36/38979632.xls

[12.10.2007]

Total expenditures - % GDP in 2005

0,0 5,0 10,0 15,0 20,0

%

Poland

Mexico

Slovak Republic

Czech Republic

Ireland

Finland

Spain

Italy

Sweden

Norway

Denmark

Iceland

Canada

Portugal

Austria

Germany

France

Switzerland

United States

Pharmaceutical expenditures - % total

0,0 10,0 20,0 30,0 40,0

%

Slovak Republic

Poland

Czech Republic

Spain

Portugal

Mexico

Italy

Canada

France

Finland

Germany

Iceland

United States

Sweden

Austria

Ireland

Switzerland

Norway

Denmark

◘ In June 2003, legal amendments dramatically changed the drug categorization system. The number of ATC groups in which at least one drug has to be fully reimbursed by law decreased to 122.

◘ The composition of the categorization committee was changed, with greater participation of health insurance companies΄ representatives and a higher emphasis on cost-effectiveness analysis.

◘ Generic substitution, maximum prices, price monitoring in the reference countries are implemented within the Slovak’s drug policy and introduction of a degressive margin is prepared.

Problems:

The cost – effectiveness threshold is not agreed.

ATC groupATC group NameName dosisdosis Price Price

per day per day €€

A02BC01A02BC01 OmeprazolOmeprazol 10 mg10 mg 0.520.52

A02BC01A02BC01 OmeprazolOmeprazol 20 mg20 mg 0.120.12

A02BC02A02BC02 PantoprazolPantoprazol 20 mg20 mg 1.451.45

A02BC02A02BC02 PantoprazolPantoprazol 40 mg40 mg 1.271.27

A02BC05A02BC05 EzomeprazolEzomeprazol 20 mg20 mg 0.860.86

A02BC05A02BC05 EzomeprazolEzomeprazol 40 mg40 mg 0.750.75

433 %

1208 %

an example:

The majority of HTA are transfrered. however

Not all participated parties within reimbursement process determine 14

transferability factors:◘ To which content it is relevant for the investigated technology

◘ How much it corresponds between the study and country’s decision

◘ The likely effect of the transferability factor on the cost-effectiveness ratio

◘ Inconsistent reimbursement decisions can be consider as one of the main reasons for the accumulation of expenditures on drugs within the Slovak Republic.

◘ The principe “VALUE FOR MONEY” as a reasonable criterion for making resource allocation decision within the health care system should be implemented more deeply.