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The EU
has an average of 7.89% of GDP for health expenditure. Croatia, Czech
Republic and Slovenia can match this but other new members spend far
less. Poland's figure is 3.8%. The EU of 25, with almost double the
population of the USA, spends about $100bn on pharmaceuticals whilst the
USA spends $200bn.
Healthcare is highly regulated in almost every European country to this
day. Each EU Member State has its own system of regulating research and
development of new drugs, manufacture, product safety, national
registration of the product, advertising, wholesale and retail
distribution. The Food and Drugs Authority (FDA) in the USA is a single
agency that offers approval of new drugs for sale in the large US
market. The European Medical Evaluation Agency (EMEA) is the EU
equivalent and is aiming to do the same for the EU. EMEA needs to
respond more quickly and liberalise its requirements on product
advertising as well as the time period for data and patent protection.
How
can the EU reform its healthcare system to offer a minimum level of
quality and service for its citizens?
Information
a)
Authentic information based on science is essential and it must be at
the centre of a European Healthcare. Information about research and
development of new drugs should be in the public domain. The public
needs to know the range of diseases for which drug cures are sought and
the level of public investment that is offered to EU research
institutions.
b)
EMEA’s period for data and patent protection of new drugs must match the
conditions of the FDA in the USA to ensure that pharmaceutical companies
do not divert their investment in R&D to the USA.
c)
Patients need access to information on diseases, doctors, hospitals and
the range of facilities available to them. The family doctor is the
first point of contact for all patients and these doctors need internet
databank access to identify the availability of consultants and hospital
beds. The patient cannot continue to rely on publications that are
available at doctors' surgeries and the enclosed leaflet in the product
package. There should be adequate information on the internet that is
authenticated by EMEA.
Skill
Utilisation
a)
Most family doctors are unable to perform diagnostic tests and hospital
references cost time and money. .
b) The
pharmacist can perform diagnostic tests and treat minor ailments thereby
saving substantial costs for national health budgets.
c)
Doctors, surgeons and nurses, supported by qualified administrators
should determine the running of each hospital.
Uninterrupted supply of medicines
The
current system of pricing for medication is based on each Member State
negotiating directly with the major pharmaceutical manufacturers. The
chargeable price is determined by the size of the nation’s health budget
and value of sales to the manufacturer. This results in substantial
price differences whereby Greece, Spain and Portugal pay far less than
UK, Germany and Scandinavian countries. This leads to parallel trade
i.e. imports from Greece and Spain into UK and Germany. Such trade
erodes the margins of pharmaceutical manufacturers forcing them to
impose supply quotas to minimise parallel trade!
The EU
should have a fixed “EU nominal price” for essential pharmaceutical
products i.e the price payable by the full-line wholesaler in every EU
Member State to the pharmaceutical manufacturer. With such a scheme in
place, each Member State can negotiate directly with the manufacturer
the reimbursement to suit its national requirements. This scheme
eliminates parallel trade and results in direct savings to national
health budgets. Also, it prevents erosion of the profits of the
pharmaceutical manufacturers allowing them to offer lower prices and
continue their investment in Research & Development of new drugs.
EU
health insurance
With
increasing expectations of higher healthcare and mobility of European
citizens across the EU for work or leisure, it is essential that EU
Member States begin a programme of shifting the burden of risk of
healthcare to private insurers. The hospitals, doctors, nurses and
health infrastructure can continue to be state owned but through tax
relief the population can be offered the opportunity to secure private
medical cover. This can be done over time for different age groups. This
transition will allow patients to choose hospitals, doctors and
treatment forcing private sector discipline on state owned hospitals as
they compete with private hospitals. This will improve the quality of
healthcare and facilitate the use of a EU HEALTHCARD that will permit
any EU citizen to receive medical care in any part of the EU. |
