Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
How are drugs reimbursed?
Useful contacts

Background
Summary
Are pharmaceuticals taxed?
How are pharmaceuticals regulated?
How are prices set/is there reference pricing?
How are drugs reimbursed?
Are hospital sales controlled?
How are pharmaceutical costs controlled?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
Humanitarian aid
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are prices changed?
How are drugs reimbursed?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Is generic drug substitution allowed?
What are wholesaler/pharmacy margins?
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are drugs reimbursed?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Prescibing limits
Patient co-payment
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
Is parallel trade influential?
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
Imports
Local
How are prices changed?
How are drugs reimbursed?
Reference pricing
Are hospital sales controlled?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Patient co-payment
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are prices changed?
How are drugs reimbursed?
Are hospital sales controlled?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Co-payments
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
Are pharmaceuticals taxed?
What size is the pharmaceutical market?
How are prices set/is there reference pricing?
How are prices changed?
Debts and price freezes
How are drugs reimbursed?
Are hospital sales a major market?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Patient co-payment
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are drugs reimbursed?
Are hospital sales controlled?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Prescribing budgets
What about generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
Other points
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
Reference price
How are drugs reimbursed?
Summary of positive list A characteristics
Summary of positive list B characteristics
Under-the-table payments
Are hospital sales controlled?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Prescribing limits
Patient co-payments
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
What to look out for
Useful contacts

How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are drugs reimbursed?
How are pharmaceutical costs controlled?
Co-payment
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
The old system (before 10 April 2002)
The current system
How are prices changed?
How are drugs reimbursed?
Are OTC prices regulated?
Are hospital sales controlled?
How are pharmaceutical costs controlled?
Prescribing limits
Promotion
Patient co-payment
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set?
How are prices changed?
How are drugs reimbursed?
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are drugs reimbursed?
Are hospital sales controlled?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Prescibing limits
Patient co-payment
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are prices changed?
How are drugs reimbursed?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
What to look out for
Useful contacts

Summary
How is the healthcare system structured?
What size is the pharmaceutical market?
Are pharmaceuticals taxed?
How are prices set/is there reference pricing?
How are drugs reimbursed?
Are hospital sales controlled?
Are OTC prices regulated?
How are pharmaceutical costs controlled?
Prescribing limits
Co-payments
Economic evaluation
What is the effect of generic drugs?
What are wholesaler/pharmacy margins?
Wholesaler margins
Pharmacy margins
What to look out for
International manufacturers’ complaints
Useful contacts

Table 2.1 Available resources in the health sector of Bosnia and Herzegovina, 1999–2000
Table 2.2 Pharmaceutical reimbursement scheme, Bosnia and Herzegovina
Table 2.3 Number of wholesalers and pharmacies (state and private) in Bosnia and Herzegovina, 1996–2000
Table 3.1 Summary of pharmaceutical cost-containment measures in Bulgaria
Table 4.1 Percentage of main sources of healthcare finance in Croatia
Table 4.2 Price build-up for medicinal products in Croatia, 2001
Table 4.3 Summary of pharmaceutical cost-containment measures in Croatia
Table 5.1 Pharmaceutical market by origin in the Czech Republic
Table 5.2 Drug expenditure in the Czech Republic, 1994–99
Table 5.3 Membership of the Czech Drug Categorisation Committee
Table 5.4 Level of reimbursement and administration criteria for hospitals in the Czech Republic
Table 5.5 Price build-up of pharmaceuticals in the Czech Republic, 1999
Table 5.6 Summary of pharmaceutical cost-containment measures in the Czech Republic
Table 6.1 Main sources of healthcare finance in Estonia
Table 6.2 Trends in healthcare expenditure in Estonia, 1992–98
Table 6.3 Sales of medicinal products in retail and hospital pharmacies in Estonia (eekm)
Table 6.4 Retail pharmacy sales in Estonia (eekm)
Table 6.5 Sales of pharmaceuticals at retail price in Estonia, 1996–98 (eekm)
Table 6.6 Top prescription drugs in Estonia, 2000
Table 6.7 Hospital pharmacy sales in Estonia (eekm)
Table 6.8 Most consumed OTC products in Estonia, 2000
Table 6.9 Top six wholesalers in Estonia by market share
Table 6.10 Wholesaler mark-ups in Estonia, 1999
Table 6.11 Pharmacy mark-ups in Estonia, 1999
Table 6.12 Summary of pharmaceutical cost-containment measures in Estonia
Table 7.1 Price increases for imported medicines in Hungary
Table 7.2 Overspend of the Drug Reimbursement Fund in Hungary, 1998–2002
Table 7.3 Number and sales of non-prescription medicines in Hungary, 1990–2000
Table 7.4 Wholesaler margins in Hungary
Table 7.5 Pharmacy mark-ups in Hungary
Table 7.6 Price build-up for medicinal products in Hungary
Table 7.7 Summary of pharmaceutical cost-containment measures in Hungary
Table 8.1 Pharmaceutical reimbursement rates in Latvia
Table 8.2 Information for pharmacy margin formula in Latvia
Table 8.3 Summary of pharmaceutical cost-containment measures in Latvia
Table 9.1 Main sources of health finance in Lithuania (%)
Table 9.2 Fixed pharmaceutical retail margins in Lithuania
Table 9.3 Turnover and reimbursement of drugs in Lithuania
Table 9.4 Wholesaler margins in Lithuania
Table 9.5 Pharmacy margins in Lithuania
Table 9.6 Summary of pharmaceutical cost-containment measures in Lithuania
Table 10.1 Main sources of healthcare finance in Macedonia, 1991–97
Table 10.2 Healthcare expenditure in Macedonia by category (percentage of total)
Table 10.3 Contribution rates into health insurance in Macedonia
Table 11.1 Who pays for healthcare in Poland
Table 11.2 Pharmaceutical market in Poland
Table 11.3 Projected pharmaceutical market in Poland
Table 11.4 Projected pharmaceutical market in Poland (usdm)
Table 11.5 Medicines on Polish reimbursement lists 1 and 2
Table 11.6 Trend in reimbursement spending in Poland
Table 11.7 How margin structure and cash collection from patients pushes Polish pharmacists to supply more expensive products (pnl)
Table 11.8 Approximate number of pharmacies and wholesalers in Poland
Table 11.9 Structure of sale channels of medicines in Poland, 1999
Table 11.10 Statutory retail margins applicable in the case of the establishment of statutory retail prices in Poland, 2002
Table 11.11 Price build-up for medicines in Poland, 2002
Table 11.12 Summary of pharmaceutical cost-containment measures in Poland
Table 12.1 The pharmaceutical market in Romania
Table 12.2 Margins for locally produced medicines in Romania
Table 12.3 Margins for medicines imported into Romania
Table 12.4 Summary of pharmaceutical cost-containment measures in Romania
Table 13.1 Pharmaceutical market data in Russia, 1998–2000 (usdbn)
Table 13.2 Wholesale and retail mark-up according to province in Russia, 2000
Table 13.3 Price build-up for medicinal products in Russia, 2000
Table 13.4 Summary of pharmaceutical cost-containment measures in Russia
Table 14.1 The pharmaceutical market in Slovakia
Table 14.2 Numbers of drugs reimbursed in Slovakia
Table 14.3 Price build-up for medicinal products in Slovakia, 2000
Table 14.4 Summary of pharmaceutical cost-containment measures in Slovakia
Table 15.1 The pharmaceutical market (€m) in Slovenia, 1998–2000
Table 15.2 Price build-up for Rx medicines in Slovenia
Table 15.3 Price build-up for OTC medicines in Slovenia
Table 15.4 Summary of pharmaceutical cost-containment measures in Slovenia
Appendix Table 1 Comparison of average income and expenditure on medicines in CEE countries, 1999
Appendix Table 2 Main features of pharmaceutical cost containment in CEE countries
Appendix Table 3 Number of pharmacies in CEE countries, 1999 (estimates)
Appendix Table 4 Pharmaceutical markets in the Baltics, 2000