Urszula Cegłowska

Objectives: To perform a systematic review, and to verify and define deficiencies in literature data on drug policy and management of access to reimbursed medicinal products in the United Kingdom, Denmark, Germany, Italy and Poland as a source of information intended to be used by government authorities in the decision-making process.
Methods: A systematic review was conducted through database search of Medline, SCOPUS, Embase and Cochrane Library, supplemented by nonsystematic review. The quality of the identified literature was critically appraised.
Results: Information necessary to develop a knowledge base was outline from 121 papers identified through database search. 0.83% of all publications were rated high in all of the assessed categories, i.e. were identified to represent high levels of consistency, coherence, strength and methodological quality.
Conclusions: In the policy decision-making process, concise recommendations based on validated data are more than needed. It is vital to rely on scientific evidence and avoid reports based on simple exchange of information or presenting single-source or unconfirmed data, including expert’s opinion.

Health care systems in OECD countries are financed by a mix of taxes, social or private insurance contributions and out-of-pocket payments. The various funding sources may have different impact on equity and redistributive effect in health care financing. The co-payments for certain medical services exist in all OECD countries, the most common are co-payments for the reimbursement drugs. This paper presents preliminary results of literature review of studies on equity in financing of health care, conducted in the framework of InterQuality Project. Recent studies on equity in the financing of reimbursement drugs in Poland and Hungary were identified, as well as earlier study, measuring horizontal inequity in utilization of prescription drugs in Denmark. The results show that inequity in financing and utilization of reimbursement drugs remained, and even increased in Hungary and Poland after implementation of health care reforms, which led to higher out-of-pocket expenditures on reimbursed drugs.