Improving data on pharmaceuticals. Meeting of OECD Health Data National Correspondents 3-4 october 2011
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1 Improving data on pharmaceuticals Meeting of OECD Health Data National Correspondents 3-4 october 2011
2 Purpose of this agenda item Present the current content of OECD health data on pharmaceuticals Propose new data collection to improve analysis of pharmaceutical markets (generic market share)
3 Data on pharmaceuticals in the OECD Health Database Data on pharmaceutical spending (SHA) Data on pharmaceutical sales, by therapeutic category Data on pharmaceutical consumption, by therapeutic category
4 Data on pharmaceutical spending (SHA) Expenditures by function: Expenditures on pharmaceuticals and other medical non-durables (dispensed to outpatient) Expenditures on prescription medicines (i.e. prescribed, covered or not by health insurance) Expenditures on over-the-counter medicines (i.e. households spending for non-prescription medicines) (Other medical non-durable = bandages, medical stocking ) Also presented by financing agent or by provider, for a majority of countries Memorandum item on total expenditures on pharmaceuticals (i.e. including spending for drugs dispensed to inpatients 15% of total) completed only by 10 countries
5 Expenditures on pharmaceuticals (HAG, 2011) Expenditure on pharmaceuticals per capita and as a share of GDP, Prescribed medicines Over-the-counter medicines United States Canada Greece ¹ Ireland ¹ Belgium 2 Germany France Italy ¹ Japan Slovak Republic ² Spain Switzerland Austria Portugal ¹ Australia Hungary OECD Netherlands Iceland Finland Slovenia Sweden Korea Norway ¹ Czech Republic United Kingdom ¹ Luxembourg ² Estonia Israel ³ Poland Denmark New Zealand Mexico ¹ Public Private 1000 USD PPP % GDP
6 Expenditures on pharmaceuticals Annual average growth in real per capita pharmaceutical expenditure, Greece Ireland Korea Estonia Slovak Republic Mexico Canada Hungary United States OECD Czech Republic Poland Netherlands Finland Japan Germany Australia Spain Iceland Belgium Austria United Kingdom Israel Portugal Slovenia France Switzerland Sweden Denmark Italy Norway Luxembourg Source: SNF (2010), Are pharmaceuticals still expensive in Norway? Annual average growth rate (%)
7 Pharmaceutical sales Definition: Sales of pharmaceutical products on the domestic market, based on retail prices. Total By ATC category Indicators available: - Total sales in NCU, US$ exchange rates and US$ PPP - Sales per capita, NCU, US$ (exchange rates $PPP) - % in total sales Availability of data: 26 countries - Total sales: 26 countries (missing Austria, Canada, Chile, Ireland, Israel, Mexico, Poland, the United States) - Sales by ATC class: 22 countries (missing: the same + Italy, Japan, Switzerland, the UK)
8 List of ATC classes (incomplete) Main groups / groups based on three levels Codes (2011 Index) Total pharmaceutical sales A-Alimentary tract and metabolism Antacids Drugs for peptic ulcer and gastro-oesophageal reflux diseases (GORD) Drugs used in diabetes B-Blood and blood forming organs C-Cardiovascular system Cardiac glycosides Antiarrhythmics, Class I and III Antihypertensives Diuretics Beta blocking agents Calcium channel blockers Agents acting on the Renin-Angiotensin system Lipid modifying agents - A A02A A02B A10 B C C01A C01B C02 C03 C07 C08 C09 C10
9 Deviations to definitions summarised in a single table Includes drugs dispensed in hospitals Includes non reimbursed drugs Major derivation from the OECD definition Australia Private hospitals only Prescription drugs only, not OTC Austria - - Belgium Yes Yes Ex-factory price Canada - - Chile - - Czech Republic - - Denmark Yes Yes Estonia Yes - Finland Yes Yes Wholesales prices France Yes Yes Ex-factory price Germany No No Retail price Greece Public hospitals only Yes Hungary Yes Yes Ex-factory price Iceland Yes Yes Ireland - - GMS insured only Israel - - Italy - - Japan Yes Yes Domestic production only, ex-factory price Korea - - Luxembourg Yes No Mexico - - Netherlands Yes before 1997, No since then Yes before 1997, No since then New Zealand No No Ex-factory price Norway Yes Yes Total sales include veterinary products Poland - - Portugal No No Slovak Republic - Yes Slovenia No - Spain No No Sweden Yes Yes VAT not included in retail price, wholesale prices before 2000 Switzerland Yes before 2001, No since then Yes Turkey - - United Kingdom No No before 1995, yes since then United States - -
10 Pharmaceutical consumption Definition: Pharmaceutical consumption according to the Anatomic Therapeutic Chemical Classification/Defined Daily Dose system, created and updated by the WHO Collaborating Center for Drug Statistics Methodology DDD = the assumed average maintenance dose per day for a drug used on its main indication in adults. Indicator: Number of DDD, per 1000 inhabitants and per day Availability: - Differs across ATC classes, ranges from 17 to 21 countries - ESAC data for antibiotics
11 Deviations from definition in a summary table Includes drugs dispensed in hospitals Includes non-reimbursed drugs Australia Private hospitals only Prescription drugs only, not OTC Austria - - Belgium No No Canada - - Chile - - Czech Republic Yes Yes Denmark Yes before 1997, no since then - Estonia Yes - Finland Yes Yes France Yes Yes Germany No No Greece Public hospitals only Yes Hungary Yes Yes Iceland Yes Yes Ireland - - Israel - - Italy - - Japan - - Korea - - Luxembourg No No Mexico - - Netherlands No No New Zealand - - Norway - Yes Poland - - Portugal No No Slovak Republic - Yes Slovenia No - Spain No No Sweden Yes Yes Switzerland - - Turkey - - United Kingdom No No United States - -
12 Warning: DDD can be revised to follow new therapeutic guidance Anticholesterols consumption, 2000 and 2009 (or nearest year) HAG Anticholesterols consumption, 2000 and 2007 (or nearest year) HAG 2009 Estonia Korea Germany Sweden Spain Slovenia Czech Republic OECD Netherlands Iceland Portugal Finland France Luxembourg Slovak Republic Hungary Denmark Norway Belgium United Kingdom Australia Defined daily dose, per people per day Germany Slovak Republic Hungary Spain Sweden Portugal Iceland Czech Republic Luxembourg OECD France Finland Netherlands Denmark Belgium Norway United Kingdom Australia n.a n.a DDD* per people per day
13
14 Include data on generic market shares? Market share % share (value) % share (volume) R: reimbursable market (outpatient); P: community pharmacy market; Rx: prescription drug market. Otherwise: total market. Source: National sources and EFPIA (2010).
15 Proposed new indicator: Generic market shares Generic market share In value In volume What is the most interesting market? (total / outpatient / reimbursed?) Pros Provides additional information on market efficiency Allows monitoring of policies promoting generic take-up Cons Differences in indicators available in countries (total market, outpatient only, reimbursed only, etc ) May not be sufficient in countries with «reference price» markets
16 Conclusion Delegates are invited to: Comment on possible existing plans to implement ATC/DDD methodology in countries for which data are unavailable Comment on the possibility to include generic market shares
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