Tender systems for outpatient pharmaceuticals in the European Union: Evidence from the Netherlands, Germany and Belgium

Abstract

page List of tables and boxes 4 List of abbreviations 5 1. Background and objective 6 2. Tender systems for pharmaceuticals in EU Member States 8 3. Data and Methods 13 4. Results 15 4.1. The Preference Policy in the Netherlands 15 Background 15 The “Transition Agreement” for pharmaceutical healt hcare 2008-2009 15 Pharmaceutical preference policy 16 Joint or Collective Preference Policy 16 Individual preference policy and its effect 17 4.2. The German Rebate System 20 Background 20 The Rebate Policy 20 4.3. The tender system in Belgium 23 Background 23 The tender policy in practice 23 5. Tender systems for ambulatory care drugs: Impact on and implications for stakeholders 25 5.1. Sickness funds 25 5.2. Patients 26 Direct benefits 26 Indirect benefits 26 5.3. Physicians 27 5.4. Pharmacies 27 Pharmacy remuneration 27 Incentive structure 28 5.5. The generics industry 29