How can the EU support sustainable innovation and access to effective antibiotics? Policy options for existing and new medicines

Antimicrobial and particularly antibiotic resistance is one of the biggest public health challenges the world faces. Over 1 million years of life are lost each year in the European Union (EU)/European Economic Area (EEA) alone due to antibiotic resistance, and it costs healthcare systems about €1.1 billion annually. These health and economic impacts are expected to worsen. Urgent steps are needed and this policy brief focuses on one area where the EU and its Member States can take effective action, fostering sustainable innovation and improving access to effective antibiotics:1. Scientific, economic, structural and regulatory ‘barriers’ continue to limit the development of novel antibiotics with innovative characteristics despite intensified international efforts.2. Reinvigorating the antibiotic pipeline requires a holistic package of incentives.3. Ensuring timely access to new and existing antibiotics is critical.4. Improving access to effective antibiotics requires both short- and longer-term measures.5. The EU has a major role to play both in combatting antimicrobial resistance (AMR) and in contributing to global solutions.

Moving from traditional to more advanced treatments in stroke care is cost-effective: A case study from Greece.

OBJECTIVES: Stroke is the most common cause of disability in high-income countries. Several countries offer a limited range of advanced treatments with implications for outcomes, disability and costs. This study estimates the burden of disability that could have been avoided through the transition from traditional (no intravenous thrombolytic therapy (IVT), or endovascular thrombectomy (EVT)) to modern stroke treatments (treatment in stroke units, IVT and EVT). We perform a cost-effectiveness analysis comparing best practice with traditional stroke care, using Greece as a case study. MATERIALS AND METHODS: A Markov model was used to calculate costs and Quality Adjusted Life Years (QALYs) for each treatment strategy, using a lifetime horizon. Data for model inputs were derived from meta-analyses of trials, and national and international cost databases. Sensitivity analyses were also performed to address potential uncertainty and test the robustness of the findings. RESULTS: Incremental effectiveness comprised 0.22 QALYs per patient and year. Best practice was cost-effective for more than 90% of all iterations (ICER for the baseline scenario: €2,109.25/QALY). Sensitivity analysis demonstrated that the findings remain robust. Considering the stroke incidence in Greece, the annual additional cost to implement best practice was calculated to be between 0.07%-0.15% of the total health expenditure. CONCLUSION: Best practice stroke treatment was cost-effective and affordable in a case study based on Greece. The results could be leveraged by including effects of preventive policies and rehabilitation. They also highlight the importance of adopting modern treatment strategies from a cost-effectiveness perspective, apart from the improved clinical outcomes.

Pharmaceutical policy in China: challenges and opportunities for reform

China has a complex pharmaceutical system that is currently undergoing significant reforms. This book provides a comprehensive overview of China's pharmaceutical system and covers key topics such as drug approvals and quality regulation, expenditure trends, pricing and reimbursement, irrational prescribing, traditional Chinese medicine, industrial policy, and the role of hospitals, primary care, and pharmacies.

How Can We Link General Medical and Behavioral Health Care? International Models for Practice and Policy.

A range of integration models for providing effective care to individuals with comorbid general medical and behavioral health conditions have been described and tested in varied settings internationally for several subsets of this population. This column examines models in three countries selected to showcase implementation in a variety of health systems: the national health system in England, nationally regulated individual insurance market in the Netherlands, and a mixture of employer-sponsored and government-funded health insurance plans in Japan. The authors describe a set of key practices for and challenges to the successful implementation of these models.

Voluntary health insurance in the European Union: a critical assessment.

The authors examine the role and nature of the market for voluntary health insurance in the European Union and review the impact of public policy, at both the national and E.U. levels, on the development of this market in recent years. The conceptual framework, based on a model of industrial analysis, allows a wide range of policy questions regarding market structure, conduct, and performance. By analyzing these three aspects of the market for voluntary health insurance, the authors are also able to raise questions about the equity and efficiency of voluntary health insurance as a means of funding health care in the European Union. The analysis suggests that the market for voluntary health insurance in the European Union suffers from significant information failures that seriously limit its potential for competition or efficiency and also reduce equity. Substantial deregulation of the E.U. market for voluntary health insurance has stripped regulatory bodies of their power to protect consumers and poses interesting challenges for national regulators, particularly if the market is to expand in the future. In a deregulated environment, it is questionable whether this method of funding health care will encourage a more efficient and equitable allocation of resources.