Affiliations: Institute for German, European and International
Medical Law, Public Health Law and Bioethics (IMGB) of the University of
Heidelberg and the University of Mannheim, Mannheim, Germany
Note: [] Address for correspondence: Institute for German, European and
International Medical Law, Public Health Law and Bioethics (IMGB) of the
University of Heidelberg and the University of Mannheim, Schloss, 68131
Mannheim, Germany. Tel.: +49 621 181 1990; Fax: +49 621 181 3555; E-mail:
marcus. [email protected]
Abstract: An increasing number of European countries use pharmacoeconomic
evaluations of innovative medicines in their pricing and reimbursement
decisions, e.g. France, the Netherlands, Belgium, U.K., Sweden and Germany.
These studies may be conducted by using different techniques from varying
viewpoints. However, they do not take into account the wider effects of cost
cutting measures upon the availability of medical alternatives and further
pharmaceutical research. Firstly, it is not known in advance whether an
innovative substance will be a blockbuster or a me-too drug. Moreover, due to
different side effects, it is necessary to have more than one drug for specific
indications. Secondly, health care policy is inseparable from economic policy
in shaping the industry structure of the pharmaceutical industry. Lower
spending for drugs may lead to less research in certain indications.
Furthermore, lower spending for drugs which have been invented and developed
within Europe may result in deprivation of pharmaceutical and medical know-how,
for example, for conducting clinical studies. It is, thus, necessary to also
include these effects in pharmacoeconomic evaluations.
Keywords: Pharmacoeconomic studies, pharmaceutical industry, health care system, research and development
