scholarly journals From heterogeneity to harmonization? Recent trends in European health policy

2007 ◽  
Vol 23 (suppl 2) ◽  
pp. S133-S142 ◽  
Author(s):  
Thomas Gerlinger ◽  
Hans-Jürgen Urban

In the European Union (EU), health policy and the institutional reform of health systems have been treated primarily as national affairs, and health care systems within the EU thus differ considerably. However, the health policy field is undergoing a dynamic process of Europeanization. This process is stimulated by the orientation towards a more competitive economy, recently inaugurated and known as the Lisbon Strategy, while the regulatory requirements of the European Economic and Monetary Union are stimulating the Europeanization of health policy. In addition, the so-called open method of coordination, representing a new mode of regulation within the European multi-level system, is applied increasingly to the health policy area. Diverse trends are thus emerging. While the Lisbon Strategy goes along with a strategic upgrading of health policy more generally, health policy is increasingly used to strengthen economic competitiveness. Pressure on Member States is expected to increase to contain costs and promote market-based health care provision.

2014 ◽  
Vol 17 (3) ◽  
pp. 123-142 ◽  
Author(s):  
Jadwiga Suchecka

The purpose of this article is to present the main directions of changes in the Estonian health care system following the transformation of the national economy and the accession of Estonia to the European Union. Special attention has been paid to the ways of sourcing, and the collection and redistribution of financial resources allocated to health care in different periods of the transformation. The initial changes introduced far-reaching decentralization of the health system, while further reforms led to his re-centralization. The intensity of the re-centralization of finance and health management processes was accelerated after 2008, when the impact of the global financial crisis on the condition of the economy of Estonia was significant. As a result of the introduced changes, Bismarck’s mixed system – a hybrid system – has been formed.


Author(s):  
G. T. Laurie ◽  
S. H. E. Harmon ◽  
E. S. Dove

This chapter begins with a discussion of the European market for health. It then analyses examples of those elements of EU health policy that contain a significant ‘rights’ dimension; outlines the legal framework for the rights dimension of health care policy in the EU; considers the emergence of elements of a European health policy; examines cross-border access to health care in the EU; and considers ethics in science and new technologies in the EU. The prospect of Brexit will not immediately remove nor necessarily diminish the influence of EU law on the field.


2020 ◽  
Vol 19 (1) ◽  
pp. 71-80
Author(s):  
Michał Wielechowski ◽  
Łukasz Grzęda

The aim of the paper was to present health care systems and assess the recent trend in health care expenditure in the European Union countries. The data source was the World Bank and European Statistical Office (Eurostat). The adopted research period covered the years 2000–2016, due to data availability. The methodology of the study was based on an analysis of data indicator series related to health care expenditure, which evaluate the national health care system performance. The research results were presented using primarily Japanese candlestick charting. The study showed that health care expenditure represented an ever-increasing burden for all the EU economies, both in absolute values and in relation to GDP. However, substantial differentiations in the amount and structure of health care expenditure were observed at the country level, having roots in the level of a country’s economic development and diverse post-war economic and political evolution. The analysis of health care expenditure structure confirmed that all three types of health care systems (Beveridge, Bismarck and mixed one) were observed in the EU, but the last one had a marginal importance. The form of system did not determine its effectiveness. On average, more than three-fourths of health care expenses were financed by general government expenditure. Out-of-pocket spending varied widely among the analysed EU member states.


2020 ◽  
Vol 13 (11) ◽  
pp. 400
Author(s):  
Arnold G. Vulto ◽  
Jackie Vanderpuye-Orgle ◽  
Martin van der Graaff ◽  
Steven R. A. Simoens ◽  
Lorenzo Dagna ◽  
...  

Introduction: Biosimilars have the potential to enhance the sustainability of evolving health care systems. A sustainable biosimilars market requires all stakeholders to balance competition and supply chain security. However, there is significant variation in the policies for pricing, procurement, and use of biosimilars in the European Union. A modified Delphi process was conducted to achieve expert consensus on biosimilar market sustainability in Europe. Methods: The priorities of 11 stakeholders were explored in three stages: a brainstorming stage supported by a systematic literature review (SLR) and key materials identified by the participants; development and review of statements derived during brainstorming; and a facilitated roundtable discussion. Results: Participants argued that a sustainable biosimilar market must deliver tangible and transparent benefits to the health care system, while meeting the needs of all stakeholders. Key drivers of biosimilar market sustainability included: (i) competition is more effective than regulation; (ii) there should be incentives to ensure industry investment in biosimilar development and innovation; (iii) procurement processes must avoid monopolies and minimize market disruption; and (iv) principles for procurement should be defined by all stakeholders. However, findings from the SLR were limited, with significant gaps on the impact of different tender models on supply risks, savings, and sustainability. Conclusions: A sustainable biosimilar market means that all stakeholders benefit from appropriate and reliable access to biological therapies. Failure to care for biosimilar market sustainability may impoverish biosimilar development and offerings, eventually leading to increased cost for health care systems and patients, with fewer resources for innovation.


2000 ◽  
Vol 39 (1) ◽  
pp. 115-127 ◽  
Author(s):  
A. van den Brink-Muinen ◽  
P.F.M. Verhaak ◽  
J.M. Bensing ◽  
O. Bahrs ◽  
M. Deveugele ◽  
...  

2008 ◽  
Vol 64 (12) ◽  
pp. 1137-1138 ◽  
Author(s):  
Silvio Garattini ◽  
Vittorio Bertele’ ◽  
Brian Godman ◽  
Alan Haycox ◽  
Björn Wettermark ◽  
...  

2011 ◽  
Vol 13 (5) ◽  
pp. 623-634 ◽  
Author(s):  
Fabio Pammolli ◽  
Massimo Riccaboni ◽  
Laura Magazzini

2020 ◽  
Vol 161 (49) ◽  
pp. 2059-2071
Author(s):  
Helga Kraxner ◽  
Andor Hirschberg ◽  
Kristóf Nékám

Összefoglaló. Az allergiás betegségekben szenvedő emberek száma világszerte, köztük Magyarországon is növekszik. Az egészségügyi ellátórendszerek azon dolgoznak, hogy minél hatékonyabban tudják felhasználni a rendelkezésre álló forrásokat. Az Allergic Rhinitis and its Impact on Asthma (ARIA) szervezet célja az allergiás náthában szenvedő betegek ellátásának javítása, szakmai ajánlások készítése, aktualizálása. Ennek egyik módja integrált betegellátási utak kidolgozása. Célunk ezek hazai elérhetővé tétele, az ajánlások széles körű elterjesztése az Európai Unió (EU) többi tagállamához hasonlóan Magyarországon is. Az ARIA más nemzetközi innovatív szervezetek bevonásával olyan integrált betegellátási utakat fejlesztett ki, amelyek allergiás nátha, esetleg társbetegsége, az asztma esetén támogatják a kezelést. Ezeket újgenerációs irányelvek kidolgozása útján alkották, amelyekhez felhasználták a mobiltechnológiából és pollenkamra-vizsgálatokból származó valós evidenciákat is. A gyógyszeres terápia optimalizálásához a vizuális analóg skálán alapuló, úgynevezett Mobil Légúti Figyelő Hálózat algoritmusát digitalizálták, és valós evidenciák felhasználásával tovább finomították. Allergén immunterápiára az ARIA a világon elsőként dolgozott ki integrált betegellátási utakat 2019-ben. A kezelési irányelvekhez való adherenciaszint alacsony, a betegek a tüneteik erőssége alapján módosítják a kezelést. A flutikazon-propionát–azelasztin kombináció hatása erősebb az intranasalis kortikoszteroidokénál, míg az utóbbi hatásosabb az oralis H1-antihisztaminoknál. A mobiltelefonokban tárolt elektronikus napló vagy más ’mobile health’ (mHealth) eszközök használata segíti a betegek kiválasztását allergén immunterápiára. Az ARIA által javasolt algoritmus megfelelőnek mutatkozott az allergiás rhinitis kezelésére, ezért ezek az irányelvek bekerülnek integrált betegellátási utakba, és részét fogják képezni az EU Egészségügyi és Élelmiszer-biztonsági Főigazgatósága digitalizált, személyközpontú gondozási anyagainak. Az allergén immunterápia hatékony az inhalatív allergének által okozott allergiás betegségekben, alkalmazását azonban korlátozni kell gondosan válogatott betegekre. Orv Hetil. 2020; 161(49): 2059–2071. Summary. The number of allergic patients is increasing all over the world, also in Hungary. Delivering effective and cost-effective health care is essential for all health care systems. ARIA (Allergic Rhinitis and its Impact on Asthma) aims to improve the care of patients who suffer from allergic rhinitis by setting up guidelines and updating them. Development of ICPs (integrated care pathways) can play an essential role in attaining this goal. Our aim is to make ICP-s developed by ARIA available also in Hungary, as is already the case in other countries of the European Union (EU). Together with other international initiatives, ARIA has worked out digitally-enabled ICPs to support care in allergic rhinitis and comorbid asthma. ICPs are based on new-generation guidelines using RWE (real-world evidence) from chamber studies and mobile technology. The MASK (Mobile Airways Sentinel NetworK) algorithm – based on visual analogue scale – was digitalized to support pharmacotherapy, and was refined by using RWE. ARIA was the first to develop ICPs for allergen immunotherapy (AIT) in 2019. Based on MASK data, patients did not follow guidelines and their adherence to treatment was poor. Patients would modify their treatments, depending on the disease control. The effect of fluticasone propionate–azelastine combination is superior to intranasal corticosteroids which are superior to oral H1-antihistamines. Electronic diaries obtained from cell phones and other ’mobile health’ (mHealth) devices help select patients for AIT. The ARIA algorithm for AR was found appropriate and no change is necessary. These guidelines will inform ICPs and will be included in the DG Santé digitally-enabled, person-centred care system. AIT is an effective treatment for allergic diseases caused by inhaled allergens. Its use should, however, be restricted to carefully selected patients. Orv Hetil. 2020; 161(49): 2059–2071.


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