Search PubMed⌕ Search

PubMed · 10172046

The transparency directive--is it working?

Abstract

The origins and nature of the Transparency Directive of the European Community (EC) are described. The Directive attempts to make the member nations of the EC clearly identify the methods they use to control pharmaceutical prices, to provide the reasons for official decisions in this area, and to set definite timetables for arriving at such decisions. These matters have long been a point of contention between national administrations and the international pharmaceutical industry. The Directive, which is legally binding, has been in force since January 1991. This discussion concludes that the Directive has been generally effective in reducing the time taken to approve drug prices, but less so in its other aims. It is stressed that much depends on the way in which rules are applied in practice. Moreover, the onus is on a company that feels it has been unfairly treated to take legal action, a step that may take time and have an uncertain outcome. Recent developments in national and Community approaches to the control of pharmaceutical expenditure are reviewed. Discontent with current arrangements is widespread and novel initiatives may be favourably received.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

M L Burstall. 1992. The transparency directive--is it working?. https://doi.org/10.2165/00019053-199200011-00004

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Cancer care, money, and the value of life: whose justice? Which rationality?

Cost-containment in oncology is a moral issue. While economists use the word "rationing" to describe all limitations on resource utilization that result from human choice, the ordinary language distinction between allocation and rationing is morally meaningful and can help oncologists to determine their proper moral role in cost-containment. It is argued that oncologists should not be required to ration at the bedside, nor should they be given financial incentives to practice frugally, nor should they be subjected to a variety of bureaucratic mechanisms to control costs indirectly. In addition, it is argued that the fact that treatments have a price does not logically imply that patients have a price. Cost-effectiveness analysis is often suggested as a means of deciding how best to allocate resources, but some of its many ethical limitations are discussed. The alternative is an open, public, participatory process about how to ration care, abandoning the formulaic pretenses of cost-effectiveness analysis, but with a commitment to reason, good will, and common sense. Oncologists would then be free to advocate for their patients within the constraints imposed by this public process.

Cost Control↗

Documentation of pharmacists' interventions in an emergency department and associated cost avoidance.

PURPOSE: An analysis was conducted of pharmacist interventions and resuscitation experiences, including pharmacist participation in a hospital emergency department (ED), and the potential cost avoidance associated with the interventions made by the pharmacists. METHODS: All pharmacists working in the ED prospectively documented the pharmacist interventions that were accepted by physicians and nursing staff and entered into a spreadsheet on a weekly basis, between September 1, 2003, and December 31, 2003. Intervention categories included the provision of drug information; recommendations for dosage adjustment, formulary interchange, initiation of medications, alternative drug therapy, discontinuation of drug therapy, changes in medication therapy due to allergy notification, drug therapy duplication prevention, or changes in the route of drug administration; questions from nursing staff; order clarifications; drug compatibility issues; patient information; toxicology; and drug interaction identification. Intervention data were analyzed and the likelihood of harm was scored; interventions were classified and analyzed by calculating average cost, probability of harm, and potential cost avoidance. RESULTS: During the study, 2150 pharmacist interventions were documented. Pharmacists participated in the care of 1042 patients triaged to the resuscitation area of the ED. Cost avoidance during the study was determined to be 1,029,776 dollars. CONCLUSION: The most commonly documented interventions made by pharmacists involved in the care of patients visiting the ED included provision of drug information, dosage adjustment recommendations, responses to questions from nursing staff, formulary interchanges, and suggestions regarding initiation of drug therapy. The potential cost avoidance attributable to the pharmacist interventions during the study period was over 1 million dollars.

Cost Control↗