The Pharmaceutical Pricing and Reimbursement Information (PPRI) initiative—Experiences from engaging with pharmaceutical policy makers

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Highlights

  • The PPRI network engages with policy makers in charge of pharmaceutical policies.

  • PPRI network members actively contribute by providing data and sharing experiences.

  • Trust-building and a common understanding are key prerequisites for cooperation.

  • The organisational framework of PPRI changed in the course of the years.

  • The policy makers are committed to PPRI as they see an added value for their work.

Abstract

Objective

To present the Pharmaceutical Pricing and Reimbursement Information (PPRI) initiative, as an illustrative example of an engagement with policy makers in the field of pharmaceutical pricing and reimbursement.

Methods

The paper is based on internal assessments and feed-back from the involved policy makers as well as an external evaluation.

Results

PPRI is a network of around 70 institutions, mainly public authorities for pharmaceutical pricing and reimbursement information from 41, mostly European, countries. It evolved from a European Commission co-funded project in 2005–2007 into a self-funded Member States borne initiative. The first years of PPRI were characterized by trust-building and developing a joint understanding and language. In the initial stages, country reports, so-called ‘Pharma Profiles’, written by policy makers, were among the most important deliverables. In the course of time, ad-hoc queries which require immediate, brief and precise answers have gained importance. PPRI is predominantly an internal network for and with policy makers; it is not a policy-making body.

Conclusions

After nearly one decade of existence, the PPRI network appears to be a sustainable network. Policy makers are committed to provide and share data and to contribute to the network as they have an added value for their daily work from access to evidence and the exchange of information and experience with fellow colleagues from other countries. The change in organisation from a research project to an independent networking initiative offers flexibility to react quickly to current challenges, but implies limited funding for the research agenda.

Introduction

Governments are struggling with providing their citizens with safe, effective and high quality medicines and, at the same time, ensuring best value for money and financial sustainability. Given the demographic developments such as aging populations, the launch of new medicines being granted high prices and stricter clinical targets [1], this challenge remains for European countries [2], [3], [4]. Policy makers have to take decisions on medicine prices and reimbursement, they need to select the most appropriate policy mix from a range of supply-side and demand-side measures, and they are recommended to promote a more rational use of medicines [5], [6], [7], [8], [9]. They need to constantly adjust their pharmaceutical policies in response to changes in the environment. Thus, information on pharmaceutical systems in other countries, particularly of the same region, and on the experiences made with specific policies elsewhere is vital for policy makers.

In the first years of this century the body of information about pharmaceutical policies in European countries was limited. A few studies were available, mainly produced by supranational institutions [10], [11], [12] and research institutions [13], [14], [15]. Contacts existed on a bilateral basis between international institutions and researchers on the one hand and public authorities in European countries on the other hand, but there were limited contacts among colleagues of Medicines Agencies or of ministries responsible for setting medicine prices or deciding on reimbursement in different countries. Having identified this urgent need for cross-country learning among policy makers, we decided to establish a network of competent authorities for pharmaceutical pricing and reimbursement. In 2004 we, organised in a consortium of an Austrian research institute and WHO, proposed a 2-year project called ‘Pharmaceutical Pricing and Reimbursement Information (PPRI)’ to the European Commission which agreed to co-fund it. The initiative is on-going though the organizational and funding framework has been modified over the years.

The objective of this paper is to present the Pharmaceutical Pricing and Reimbursement Information (PPRI) project as an illustrative example of an engagement with policy makers in the field of pharmaceutical pricing and reimbursement. We will discuss how the PPRI project evolved, how the organisational and funding framework was modified over the years and how these changes impacted the working methods and deliverables. Particularly, we will look into how the needs, particularly information needs, of the policy makers involved have changed following successful opportunities for cross-country learning. Finally, we will explore, on the example of PPRI, supportive and limiting factors of such an initiative, including challenges for sustainability, in order to allow similar undertakings to learn from these experiences.

Section snippets

Methods

The presentation of the Pharmaceutical Pricing and Reimbursement Information (PPRI) project and its changes over time is based on factual background information to set the scene, along with an assessment of the engagement with policy makers. For the analysis we draw from observations made by the authors, feedback provided by the involved policy makers at regular intervals during reflection rounds on the added value and sustainability of the initiative, and two external reports. The latter

From an European Commission co-funded project to a self-sustainable initiative

The Pharmaceutical Pricing and Reimbursement Information (PPRI) project started in April 2005, with the aim to develop a network of competent authorities to improve information and knowledge on the pharmaceutical systems in Europe and to facilitate cross-country learning among policy makers since no such initiative existed at that time. It was commissioned under the Public Health Information Programme of the European Commission (EC), Health and Consumer Protection Directorate-General and

Discussion

This paper describes the Pharmaceutical Pricing and Reimbursement Information (PPRI) network as an example for an engagement with policy makers, and presents its activities from its beginning in 2005 until today.

The PPRI initiative changed over the years, and the information needs of the involved policy makers also changed. One might argue that this is the result of successful capacity building activities in the early stages of PPRI when, due to limited information in the public domain, the

Conclusions

The engagement with the policy makers in the PPRI network has proved to be a long-term cooperation, in spite of limitations in funding. The sustainability of the network has been ensured up to now by the contributions of the policy makers involved: Seeing a personal added value for their daily work, they are committed to getting involved and contributing time resources, ideas and data.

The major principles of PPRI are trust and mutual respect among the network members, a common understanding of

Ethical approval

Not declared.

Funding

No specific funding was provided for writing the article.

No writing assistance was utilized in the production of this manuscript.

Competing interests

None declared.

Acknowledgements

We deeply thank the policy makers involved the PPRI (Pharmaceutical Pricing and Reimbursement Information) network for their active participation and their willingness to share data and experiences. Their commitment has contributed to the success and sustainability of the PPRI. It is the policy of PPRI not to disclose the names of the policy makers, but their affiliated institutions were referred to in the article.

Furthermore, we are grateful to (former) colleagues of the Austrian Health

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