Warsaw 29 October 2007 1

Pharmaceutical Pricing & Reimbursement Information ÖBIG

Monitoring of doctor‘s prescription PPRI Project

Christine LeopoldGesundheit Österreich GmbH

PPRI ConferenceWarsaw, 29 October 2007

Warsaw 29 October 2007 2

Pharmaceutical Pricing & Reimbursement Information ÖBIG

Prescription guidelines

Introduction of guidelines to promote the appropriate and economic prescribing of pharmaceuticals

Indicative (most countries) / obligatory (AT, DE, HU, NO, SK)

Example AT: “Guidelines on Economic Prescribing” provide that in case of several similar therapeutic options being available a physician has to choose the most cost-effective one

Prescription guidelines

Warsaw 29 October 2007 3

Pharmaceutical Pricing & Reimbursement Information ÖBIG

Prescription monitoring

In most countries Third Party Payers monitor the prescription habits of their contracted doctors – in raw cases sanctions

Example BE

Database system (Pharmanet) operated by Social Health Insurance to monitor the consumption and prescription pattern

All reimbursable pharmaceuticals dispensed in pharmacies

Pharmacies submit their data monthly - database is updated every three months

Individual profiles of physicians -> feedback on prescribing patterns

No monitoring of individual patients consumption since data is made anonymous

Prescription monitoring

Warsaw 29 October 2007 4

Pharmaceutical Pricing & Reimbursement Information ÖBIG

Pharmaceutical budgets for doctors

Third Party Payers set ex-ante a maximum amount of money to be spent on pharmaceuticals in a specific region or period of time by a contracted doctor

Obligatory budgets in DE, LV, SE, SK – although in most cases still no sanctions

Different criteria for calculating the budgets, e.g.:

the number of patients

the age groups of the patients and their diseases

Pharmaceutical budgets