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Streamlining breast cancer and colorectal cancer biosimilar regulations to improve treatment access in Latin America: an expert panel perspective. Lancet Oncol 2022; 23:e348-e358. [DOI: 10.1016/s1470-2045(22)00121-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 11/20/2022]
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Popovici I, Carvajal MJ, Peeples P, Rabionet SE. Nature and Composition of Earnings Reported by Health Economists and Related Professionals: Gender, Education, and job Characteristics Matter. Health Serv Res Manag Epidemiol 2022; 9:23333928221106039. [PMID: 35769113 PMCID: PMC9234843 DOI: 10.1177/23333928221106039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Despite the fast growth of the workforce comprising health economics (HE),
outcomes research (OR), and market access (MA) professionals, little is
known about their earnings determination. Only three studies have examined
their earnings and none has considered the number of hours worked,
traditionally a critical component of income determination models. Objectives (i) Estimate an indicator of annual earnings of HE/OR/MA professionals,
comparing male versus female and U.S. versus non-U.S. earnings levels, and
(ii) assess the magnitude of the effect of selected human-capital and
job-related covariates on their annual earnings determination. Methods The study used 2019 self-reported survey data from a sample of 304 HE/OR/MA
professionals registered in the HealthEconomics.com global subscriber list.
A two-way classification model with multiple replications was used to
identify and test earnings variations of HE/OR/MA professionals across
genders and locations. An earnings determination function using ordinary
least squares was used to identify disparities in response to covariates
including average workweek, human-capital stock, and job-related variables
by gender and location. Results Substantial earning disparities were observed between HE/OR/MA professionals
living in the U.S. and those living in other countries. Non-U.S. respondents
exhibited earnings gaps of 44.7% in wages/salaries and 46.8% in total
earnings relative to their U.S. counterparts with greater gaps for women
than men. The female earnings gap outside the U.S. was considerably greater
than in the U.S. Holding a graduate degree; working in a pharmaceutical or
biotechnology firm; age, a proxy for experience; and working remotely
impacted earnings differentials across different subgroups. Conclusions The findings of this paper shed light into the nature and composition of
earnings of HE/OR/MA professionals across genders and locations. Exploring
the dynamics of earning disparities by gender and location has increased in
relevance given the rapidly-changing and uncertain job market environment
driven by the COVID-19 pandemic.
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Affiliation(s)
- Ioana Popovici
- Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, College of Pharmacy, Fort Lauderdale, FL, USA
| | - Manuel J. Carvajal
- Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, College of Pharmacy, Fort Lauderdale, FL, USA
| | - Patti Peeples
- Founder and CEO, HealthEconomics.com and Principal Researcher, HE Institute, Jacksonville, FL
| | - Silvia E. Rabionet
- Department of Sociobehavioral and Administrative Pharmacy, Nova Southeastern University, College of Pharmacy, Fort Lauderdale, FL, USA
- University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
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Popovici I, Carvajal MJ, Peeples P, Rabionet SE. Disparities in the Wage-and-Salary Earnings, Determinants, and Distribution of Health Economics, Outcomes Research, and Market Access Professionals: An Exploratory Study. PHARMACOECONOMICS - OPEN 2021; 5:319-329. [PMID: 33428118 PMCID: PMC7797494 DOI: 10.1007/s41669-020-00247-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 05/21/2023]
Abstract
OBJECTIVE The aim was to estimate the wage-and-salary earnings of a sample of health economics, outcomes research, and market access (HE/OR/MA) professionals; compare male versus female and US versus non-US earnings; assess the magnitude of the effect of several human-capital and job-related covariates on the determination of earnings; and examine inequality in the distribution of earnings. METHODS The study used self-reported survey data collected in 2017 from a subset of HE/OR/MA professionals in the HealthEconomics.com global subscriber list. HE/OR/MA professionals in this subset completed a questionnaire. The sample consisted of 372 participants who reported their wage-and-salary earnings and other indicators. The sample was not necessarily representative of the global HE/OR/MA community. The study methods included a two-way classification model with multiple replications, an ordinary least-squares model, and three inequality indicators. PRINCIPAL FINDINGS The results suggested substantial disparities between the wage-and-salary earnings of respondents living in the USA and those living in other countries; mild gender disparities in earnings; greater inequality outside the USA than within the USA; and, within each location, more unequal distribution of men's earnings than that of women's earnings. CONCLUSIONS Although the findings may not be extrapolated to the worldwide population of HE/OR/MA professionals, they provide a point of comparison with earlier studies and offer insights into the mechanics of one of the most innovative and fastest growing health-sector workforce segments in developed as well as emerging countries.
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Affiliation(s)
- Ioana Popovici
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328-2018 USA
| | - Manuel J. Carvajal
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328-2018 USA
| | - Patti Peeples
- HE Institute, HealthEconomics.com, 1327 Walnut Street, Jacksonville, 32206 FL USA
| | - Silvia E. Rabionet
- Department of Sociobehavioral and Administrative Pharmacy, College of Pharmacy, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL 33328-2018 USA
- University of Puerto Rico, Medical Sciences Campus, P.O. Box 365067, San Juan, 00936-5067 Puerto Rico USA
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Moorkens E, Broux H, Huys I, Vulto AG, Simoens S. Economic evaluation of biosimilars for reimbursement purposes - what, when, how? JOURNAL OF MARKET ACCESS & HEALTH POLICY 2020; 8:1739509. [PMID: 32284827 PMCID: PMC7144192 DOI: 10.1080/20016689.2020.1739509] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/24/2020] [Accepted: 02/28/2020] [Indexed: 06/11/2023]
Abstract
Background: Limited previous research and guidelines on the design of economic evaluation for biosimilars have led to unresolved methodological questions on how to assess biosimilars. Objectives: We want to raise awareness of and explore methodological issues for the economic evaluation of biosimilars. Methods: We relied on a literature review, exploratory interviews, and our experiences. Results and Conclusions: In the majority of cases in which reimbursement for a biosimilar is sought, it will not be necessary to conduct an economic evaluation, given that the reference product is already reimbursed and standard of care. If the latter is not the case, a full economic evaluation of the biosimilar versus standard of care is needed. This might also be needed in the case of differences in administration form or adherence (for example, due to a nocebo effect) and to take into account value-added services. The entry of biosimilars and of next-generation biological products should trigger a re-assessment of the entire product class. HTA bodies and reimbursement agencies should provide clear guidance on how to assess the value of a biosimilar in each of these circumstances.
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Affiliation(s)
- Evelien Moorkens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Hannah Broux
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Arnold G. Vulto
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Steven Simoens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
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Biosimilar Knowledge Among Oncology/Hematology Team Members in Colorado, USA: An Educational Initiative and Follow-Up Survey. BioDrugs 2019; 32:499-506. [PMID: 30120705 DOI: 10.1007/s40259-018-0301-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND No data exist regarding oncology/hematology team members' knowledge of and views on biosimilars in Colorado, USA. Published research has suggested that health professionals may have a poor understanding of many issues related to biosimilars. OBJECTIVES Our goal was to increase oncology/hematology team members' knowledge of biosimilars and then use an anonymous online survey to assess the knowledge gained. We also aimed to examine oncology/hematology team members' overall interest in the subject and their motivation to learn more about biosimilars in the future. METHODS In phase I of the project, we developed printed materials covering many topics related to biosimilars, such as definition, regulation, and interchangeability, and the potential of biosimilars in optimal combination therapy for cancer. We distributed our brochures to each participating oncology/hematology office in Colorado. The oncology/hematology team members were then asked to complete the survey. RESULTS A total of 62 team members responded to our survey. Nearly three-quarters of participants were oncology nurses or oncology nurse practitioners. More than 90% of survey respondents identified correct answers about the definition, regulations, interchangeability, safety, cost issues, and use of biosimilars in oncology and in older patients with cancer. Overall, and compared with those who had low levels of interest and motivation, significantly more (p < 0.05) study participants were interested in the subject of biosimilars [57 (92%) vs. 5 (8%)], motivated to learn more about them [59 (95%) vs. 3 (5%)], and interested in sharing information about biosimilars with colleagues and patients [51 (82%) vs. 11 (18%)]. CONCLUSION Our results demonstrate that oncology/hematology team members participating in our study became familiar with many important issues related to biosimilars. Many survey respondents were highly motivated to participate in future training focused on biosimilars, which should pave the way for new educational projects in the area.
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Moorkens E, Jonker-Exler C, Huys I, Declerck P, Simoens S, Vulto AG. Overcoming Barriers to the Market Access of Biosimilars in the European Union: The Case of Biosimilar Monoclonal Antibodies. Front Pharmacol 2016; 7:193. [PMID: 27445826 PMCID: PMC4925708 DOI: 10.3389/fphar.2016.00193] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/17/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND In 2014, six of the top ten blockbuster medicines were monoclonal antibodies. This multibillion-dollar market with expiring patents is the main driver for the development of biosimilar mAbs. With the ever-increasing cost of healthcare and the economic pressure to reduce or sustain healthcare expenses, biosimilars could be instrumental in reducing costs for medication and increasing patient access to treatment. OBJECTIVES The aim of this study is to identify and describe the barriers to market access of biosimilar mAbs in the European Union and to analyze how these barriers could be overcome. METHODS A narrative literature review was carried out using the databases PubMed, Embase, and EconLit. Studies were published in English or Dutch. Additionally, the reference list of the articles was checked for relevant studies. Articles and conference papers known to the authors were included as well. Articles were also identified by searching on the website of the Generics and Biosimilars Initiative (GaBI) journal. RESULTS Six barriers were identified based on available literature: The manufacturing process, the regulatory process, intellectual property rights, lack of incentive, the impossibility of substitution, and the innovator's reach. These six barriers are presented as a possible framework to study the market access of biosimilar mAbs. Based on the literature search, recommendations can be made to overcome these barriers: (i) invest initially in advanced production processes with the help of single-use technology, experience or outsourcing (ii) gain experience with the regulatory process and establish alignment between stakeholders (iii) limit patent litigation, eliminate evergreening benefits, build out further the unitary patent and unified patent litigation system within the EU (iv) create demand-side policies, disseminate objective information (v) change attitude toward biosimilar switching/substitution, starting with physician, and patient education (vi) differentiate the biosimilar by service offerings, use an appropriate comparator in cost-effectiveness analyses. CONCLUSIONS Barriers to the market access of biosimilar mAbs could be reduced when more transparency and communication/education is used in all steps toward market access in order to increase the trust in biosimilar mAbs by all stakeholders. Only then biosimilar mAbs will be able to fully capture their cost saving potential.
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Affiliation(s)
- Evelien Moorkens
- Department of Pharmaceutical and Pharmacological Sciences, University of LeuvenLeuven, Belgium
| | - Clara Jonker-Exler
- Hospital Pharmacy, The Erasmus University Medical CenterRotterdam, Netherlands
| | - Isabelle Huys
- Department of Pharmaceutical and Pharmacological Sciences, University of LeuvenLeuven, Belgium
| | - Paul Declerck
- Department of Pharmaceutical and Pharmacological Sciences, University of LeuvenLeuven, Belgium
| | - Steven Simoens
- Department of Pharmaceutical and Pharmacological Sciences, University of LeuvenLeuven, Belgium
| | - Arnold G. Vulto
- Hospital Pharmacy, The Erasmus University Medical CenterRotterdam, Netherlands
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Affiliation(s)
- François Bocquet
- a Faculty of Pharmacy , Paris Descartes University, Sorbonne Paris Cité, Paris, France, Health Law Institute, Inserm, UMR S 1145, Paris Descartes University, Sorbonne Paris Cité, Paris, France, and General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris , France
| | - Pascal Paubel
- a Faculty of Pharmacy , Paris Descartes University, Sorbonne Paris Cité, Paris, France, Health Law Institute, Inserm, UMR S 1145, Paris Descartes University, Sorbonne Paris Cité, Paris, France, and General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP) , Paris , France
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Dylst P, Vulto A, Simoens S. Barriers to the uptake of biosimilars and possible solutions: a Belgian case study. PHARMACOECONOMICS 2014; 32:681-691. [PMID: 24803078 DOI: 10.1007/s40273-014-0163-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Biosimilars are medicinal products that are similar to a biopharmaceutical that has already been authorised. As biopharmaceuticals are expected to dominate the best-selling pharmaceuticals worldwide by 2016, the emergence of biosimilars imposes an important challenge for governments. At this moment, the uptake of biosimilars in Belgium is limited, with market shares close to 0%. OBJECTIVE This study aimed to identify the barriers that impede the uptake of biosimilars in Belgium. METHODS Semi-structured interviews were conducted to investigate in depth the barriers to the uptake of biosimilars in Belgium. Respondents were selected through selective sampling so that all different stakeholders were represented (authorities, physicians, pharmacists, patients, academics and industry). Respondents were contacted by e-mail and letter with a request for participation. A thematic framework was used to analyze the data. RESULTS Three main barriers to the uptake of biosimilars in the Belgian market were identified: a lack of confidence towards biosimilars by some stakeholders; uncertainty about the interchangeability and substitution of biosimilars; and a hospital financing system that discourages the use of them. Providing all stakeholders with objective information on the concept of biosimilars, reforming the financing of hospitals, developing and implementing prescription quota in hospitals, setting up patient registries for biosimilars and speeding up the pricing and reimbursement process of biosimilars are suggested solutions to increase the uptake of biosimilars in Belgium. CONCLUSIONS To fully capture the potential savings of biosimilars, governments should take measures to increase their uptake. The Belgian government, and also the manufacturers of biosimilars, should take measures to reduce the uncertainties related to biosimilars and raise confidence among prescribers. In addition, the financing of hospitals should be reformed and incentives should be developed to stimulate physicians to prescribe biosimilars.
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Affiliation(s)
- Pieter Dylst
- KU Leuven, Department of Pharmaceutical and Pharmacological Sciences, Herestraat 49, O&N 2, P.O. Box 521, 3000, Leuven, Belgium,
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Farfan-Portet MI, Gerkens S, Lepage-Nefkens I, Vinck I, Hulstaert F. Are biosimilars the next tool to guarantee cost-containment for pharmaceutical expenditures? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2014; 15:223-8. [PMID: 24271016 PMCID: PMC3950601 DOI: 10.1007/s10198-013-0538-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 10/16/2013] [Indexed: 05/08/2023]
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Impact of aeration strategies on fed-batch cell culture kinetics in a single-use 24-well miniature bioreactor. Biochem Eng J 2014. [DOI: 10.1016/j.bej.2013.11.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Beware of the commercialization of human cells and tissues: situation in the European Union. Cell Tissue Bank 2012; 13:487-98. [PMID: 22718427 PMCID: PMC3432198 DOI: 10.1007/s10561-012-9323-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 06/05/2012] [Indexed: 11/16/2022]
Abstract
With this analysis we would like to raise some issues that emerge as a result of recent evolutions in the burgeoning field of human cells, tissues, and cellular and tissue-based product (HCT/P) transplantation, and this in the light of the current EU regulatory framework. This paper is intended as an open letter addressed to the EU policy makers, who will be charged with the review and revision of the current legislation. We propose some urgent corrections or additions to cope with the rapid advances in biomedical science, an extensive commercialization of HCT/Ps, and the growing expectation of the general public regarding the ethical use of altruistically donated cells and tissues. Without a sound wake-up call, the diverging interests of this newly established ‘healthcare’ industry and the wellbeing of humanity will likely lead to totally unacceptable situations, like some of which we are reporting here.
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Simoens S. Use of economic evaluation in decision making: evidence and recommendations for improvement. Drugs 2011; 70:1917-26. [PMID: 20883050 DOI: 10.2165/11538120-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.
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Affiliation(s)
- Steven Simoens
- Research Centre for Pharmaceutical Care and Pharmaco-economics, Katholieke Universiteit Leuven, Leuven, Belgium.
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Godman B, Shrank W, Wettermark B, Andersen M, Bishop I, Burkhardt T, Garuolienè K, Kalaba M, Laius O, Joppi R, Sermet C, Schwabe U, Teixeira I, Tulunay FC, Wendykowska K, Zara C, Gustafsson LL. Use of Generics-A Critical Cost Containment Measure for All Healthcare Professionals in Europe? Pharmaceuticals (Basel) 2010; 3:2470-2494. [PMID: 27713363 PMCID: PMC4033935 DOI: 10.3390/ph3082470] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 07/27/2010] [Accepted: 08/04/2010] [Indexed: 01/07/2023] Open
Abstract
Pharmaceutical expenditures in ambulatory care rose rapidly in Europe in the 1990s and early 2000s. This was typically faster than other components of healthcare spending, leading to reforms to moderate future growth. A number of these centered on generic medicines with measures to lower reimbursed prices as well as enhance their prescribing and dispensing. The principal objective of this paper is to review additional measures that some European countries can adopt to further reduce reimbursed prices for generics. Secondly, potential approaches to address concerns with generics when they arise to maximize savings. Measures to enhance the prescribing of generics will also briefly be discussed. A narrative review of the extensive number of publications and associated references from the co-authors was conducted supplemented with known internal or web-based articles. In addition, health authority and health insurance databases, principally from 2001 to 2007, were analyzed to assess the impact of the various measures on price reductions for generic omeprazole and generic simvastatin vs. pre-patent loss prices, as well as overall efficiency in Proton Pump Inhibitor (PPI) and statin prescribing. The various initiatives generally resulted in considerable lowering of the prices of generics as well as specifically for generic omeprazole and generic simvastatin vs. pre-patent loss prices. At one stage in the UK, generic simvastatin was just 2% of the originator price. These measures also led to increased efficiency for PPI and statin prescribing with reimbursed expenditure for the PPIs and statins either falling or increasing at appreciably lower rates than increases in utilization. A number of strategies have also been introduced to address patient and physician concerns with generics to maximize savings. In conclusion, whilst recent reforms have been successful, European countries must continue learning from each other to fund increased volumes and new innovative drugs as resource pressures grow. Policies regarding generics and their subsequent impact on reimbursement and utilization of single sourced products will continue to play a key role to release valuable resources. However, there must continue to be strategies to address concerns with generics when they exist.
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Affiliation(s)
- Brian Godman
- Institute for Pharmacological Research 'Mario Negri', Via Giuseppe La Masa 19, 20156 Milan, Italy.
- Prescribing Research Group, University of Liverpool Management School, Chatham Street, Liverpool L69 7ZH, UK.
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden.
| | - William Shrank
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, suite 3030. Boston, MA 02120, USA.
| | - Bjorn Wettermark
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden.
- Centre for Pharmacoepidemiology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
| | - Morten Andersen
- Centre for Pharmacoepidemiology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden.
| | - Iain Bishop
- Information Services Healthcare Information Group, NHS Scotland, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK.
| | - Thomas Burkhardt
- Hauptverband der Österreichischen Sozialversicherungsträger, Kundmanngasse 21, A-1031 Wien, Austria.
| | - Kristina Garuolienè
- Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, University of Vilnius, M. K. Čiurlionio g. 21/27, Vilnius, Lithuania.
- Medicines Reimbursement Department, National Health Insurance Fund, Kalvarijų Str. 147, Vilnius, Lithuania.
| | - Marija Kalaba
- Republic Institute for Health Insurance, Jovana Marinovica 2, 11000 Belgrade, Serbia.
| | - Ott Laius
- State Agency of Medicines, Nooruse 1, 50411 Tartu, Estonia.
| | - Roberta Joppi
- Institute for Pharmacological Research 'Mario Negri', Via Giuseppe La Masa 19, 20156 Milan, Italy.
- Pharmaceutical Drug Department, Azienda Sanitaria Locale of Verona, Verona, Italy.
| | | | - Ulrich Schwabe
- University of Heidelberg, Institute of Pharmacology, D-69120 Heidelberg, Germany.
| | - Inês Teixeira
- Center for Health Evaluation & Research, National Association of Pharmacies (ANF), Rua Marechal Saldanha, n.º 1, 1249-069 Lisboa, Portugal.
| | - F Cankat Tulunay
- Department of Pharmacology, Medical School of Ankara University, Sihhiye, Ankara 06100, Turkey.
| | | | - Corinne Zara
- Barcelona Health Region, Catalan Health Service, Esteve Terrades 30, 08023 Barcelona, Spain.
| | - Lars L Gustafsson
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden.
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