The impact of pharmaceutical cost containment policies on the range of medicines available and subsidized in Finland and New Zealand.

摘要

OBJECTIVE: To identify differences in the range of medicines available and subsidized for ambulatory care in Finland and New Zealand. METHODS: Medical entities listed in national product information sources and their subsidy statuses were compared. The number and overlap of entities available and subsidized were determined. Differences in the age of subsidized medicines were compared using the date of first registration. Differences in licensing delays were compared using a selection of new innovative medicines that provide health gain. RESULTS: Within the inclusion criteria, 779/763 entities were available and 495/471 subsidized in Finland/New Zealand, of which around 30% (30.9% Finland, 29.5% New Zealand) were not available and approximately 40% (41.4% Finland, 38.4% New Zealand) not subsidized in the other country. The proportion of fully subsidized entities was higher in New Zealand (86.2%/29.1%). The entities only subsidized in New Zealand were significantly older than those only subsidized in Finland and the share of licensed and launched innovative medicines was significantly smaller in New Zealand. The differences were equally distributed across the therapeutic groups but clinically relevant differences were rarely found. CONCLUSIONS: In New Zealand, medicines are heavily subsidized across therapy groups, but those uniquely subsidized were older entities. In Finland, more "newer" medicines are subsidized and available, but the level and coverage of subsidy is lower and thus, the patient cost burden is higher. The cost containment policies adopted seem to affect patients' access to medicines mainly by availability in New Zealand and by affordability in Finland.