The New and Old Europe: East-West Split in Pharmaceutical Spending.
The New and Old Europe: East-West Split in Pharmaceutical Spending.
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DOI：
10.3389/fphar.2016.00018
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发表时间：
2016
影响因子：
5.6
通讯作者：
Kanjevac T
中科院分区：
文献类型：
--
作者：
Jakovljevic M;Lazarevic M;Milovanovic O;Kanjevac T
自1989年地缘政治发展以来，东欧前中央计划经济国家在国家药品支出演变方面与其自由市场的西欧国家相比走了明显不同的道路。截至1989年，在自由市场经济国家，长期药品支出占保健总支出的百分比正在下降。早在20世纪90年代初，东欧转型国家的失业率就处于较高水平，而且实际上还在继续增长。最近几十年来，在大多数中欧和东欧国家，公共资金在药品总支出中所占份额稳步下降。相反的情况是，为了本国公民的利益，欧盟15国成功地增加了处方药的公共资金。按购买力平价计算，东欧人均药品支出的年增长速度比西方国家至少快20%。在同一年中，与欧盟15国相比，中东欧地区药品在卫生支出中所占份额的年增长率快了8倍。私人和自付开支在前社会主义国家中占主导地位。从长远来看，负担能力问题加上转型期经济中日益严重的收入不平等将对公平提供药品和可持续融资构成严重挑战。突出了
Since the geopolitical developments of 1989, former centrally planned economies of Eastern Europe followed distinctively different pathways in national pharmaceutical expenditure evolution as compared to their free market Western European counterparts. Long term spending on pharmaceuticals expressed as percentage of total health expenditure was falling in free market economies as of 1989. Back in early 1990s it was at higher levels in transitional Eastern European countries and actually continued to grow further. Public financing share of total pharmaceutical expenditure was steadily falling in most Central and Eastern European countries over the recent few decades. Opposed scenario were EU-15 countries which successfully increased their public funding of prescription medicines for the sake of their citizens. Pace of annual increase in per capita spending on medicines in PPP terms, was at least 20% faster in Eastern Europe compared to their Western counterparts. During the same years, CEE region was expanding their pharmaceuticals share of health spending in eight fold faster annual rate compared to the EU 15. Private and out-of-pocket expenditure became dominant in former socialist countries. Affordability issues coupled with growing income inequality in transitional economies will present a serious challenge to equitable provision and sustainable financing of pharmaceuticals in the long run. HIGHLIGHTS