The cost of prescription medicines to patients

The study compares the cost-sharing (co-payment) arrangements for prescribe d medicines in a sample of EU countries. Through a set of typical prescript ion scenarios, the cost burden to individual patients of prescriptions are examined, in the context of drug price, and from the perspective of therape utic need. The cost to patients of medicines is consistently lower in some, and higher in other, countries, regardless of the type of prescription cha rge system. Fixed charge systems, as opposed to graduated co-payment system s, are obviously more likely to lead to similar charges for the treatment o f comparable clinical conditions, but depending on the level of the charge, can result in the patient paying a higher charge than the price of the dru g to the health organisation. Exemption from charges for prescription medic ines, commonly relate to clinical condition and level of income. Some syste ms also have age-related criteria and apply ceilings to the total prescript ion cost burden borne by the patient. The impact on patient costs of specif ic policy formulations is discussed and a sproposal is made for cost conver gence for comparable therapies. The method used in this study may also prov ide a route for investigating model systems prior to implementation. (C) 20 00 Elsevier Science Ireland Ltd. All rights reserved.