Objective: The objective of this study was to provide an overview about the existence and types of discounts and rebates granted to public payers by the pharmaceutical ind'/>
Discounts and rebates granted to public payers for medicines in European countries
id="__p1" class="p p-first">Objective: The objective of this study was to provide an overview about the existence and types of discounts and rebates granted to public payers by the pharmaceutical industry in European countries. id="__p2">Methods: Data were collected via a questionnaire in spring 2011. Officials from public authorities for pharmaceutical pricing and reimbursement represented in the PPRI (Pharmaceutical Pricing and Reimbursement Information) network provided the information and reviewed the compilation. id="__p3">Results: Information is available from 31 European countries. Discounts and rebates granted to public payers by pharmaceutical industry were reported for 25 European countries. Such discounts exist both in the in- and out-patient sectors in 21 countries and in the in-patient sector only in four countries. Six countries reported not having any regulations or agreements regarding the discounts and rebates granted by industry. The most common discounts and rebates are price reductions and refunds linked to sales volume but types such as in-kind support, price-volume and risk-sharing agreements are also in place. A mix of various types of discounts and rebates is common. Many of these arrangements are confidential. Differences regarding types, the organizational and legal framework, validity and frequency of updates and the amount of the discounts and rebates granted exist among the surveyed countries. id="__p4" class="p p-last">Conclusions: In Europe, discounts and rebates on medicines granted by pharmaceutical industry to public payers are common tools to contain public pharmaceutical expenditure. They appear to be used as a complimentary measure when price regulation does not achieve the desired results and in the few European countries with no or limited price regulation. The confidential character of many of these arrangements impedes transparency and may lead to a distortion of medicines prices. An analysis of the impact on these measures is recommended.
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机译：id =“ __ p1” class =“ p p-first”>目的：本研究的目的是概述欧洲国家制药业给予公共付款者的折扣和回扣的存在和类型。方法：数据是通过2011年春季的问卷调查收集的。PPRI（药品定价和报销信息）网络中代表政府定价和报销的政府官员提供了该信息并审查了汇编。结果：信息可从31个欧洲国家获得。据报道，有25个欧洲国家获得了制药业给予公共付款人的折扣和返利。此类折扣在21个国家的住院和门诊部门以及仅在四个国家的住院部门均存在。六个国家报告没有关于行业所给予的折扣和返利的任何法规或协议。最常见的折扣和返利是与销售量相关的降价和退款，但也有实物支持，价格量和风险分担协议等类型。各种类型的折扣和返利是很常见的。这些安排中有许多是保密的。被调查国家之间在类型，组织和法律框架，更新的有效性和频率以及所给予的折扣和折扣的数量方面存在差异。 id =“ __ p4” class =“ p p-last”>结论：在欧洲，制药行业授予公共付款者的药品折扣和折扣是控制公共药品支出的常用工具。当价格监管未达到预期效果时，并且在少数没有或没有价格监管的欧洲国家中，它们似乎可以作为一种补充措施。其中许多安排的机密性阻碍了透明度，并可能导致药品价格扭曲。建议对这些措施的影响进行分析。
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