Cross-country variation in medicines use; a pharmaceutical system perspective

摘要: Access to effective and affordable medicines (medical care) is considered an equitable right for all (European) citizens. Ensuring access medical care a challenge governments health systems across the world. Choices need be made about which medicine can used in what quantity because there are many (effective) available on market, but resources limited. These choices may differ among countries influenced by (large) number of factors. In addition, it likely that any given level use specific one country determined set factors might vary another country. last decade interest has arisen studying variation integrated way, i.e. including relevant pharmaceutical system parameters, enhance our understanding causes consequences this variation. This thesis includes studies cross-national from perspective. The various multiple conditions measured, while also taking into account An overview national policies global view outpatient consumption followed five comparative Europe; two with regard TNF alpha inhibitors (biologicals treatment rheumatoid arthritis), psychotropic time market relation participation European regulatory activity. address importance quality data collection, equal new (TNFalpha inhibitors), impact cultural diversity reimbursement delay restrictions (psychotropic medicines), contribution EU member states process light availability uptake received granting authorization 2004. Finally, focus single policy: delisting benzodiazepines Netherlands 2009. One study describes volume patients newly diagnosed anxiety or sleeping disorder, assesses information services context policy intervention. identified critical performing successful extent perspective; a) improve harmonization combine data(sources) b) have adequate environmental context. By comparing combining datasets researchers detect more subtle complex associations variables, end interpretation caused historical societal developments – contextual environment. Furthermore, essential hypothesize why certain influence use, mechanisms. shown currently databases epidemiological methods provide ample opportunities