A very recent survey on the “diffusion of medicines in Europe”, carried out by Prof. Oliver Schoffski of Nuremberg University on behalf of the European Federation of Pharmaceutical Industries and Associations (EFPIA), has revealed enormous differences in the availability of innovatory medicines among the various European Countries. EFPIA represents the common perspectives of approximately 2000 Pharmaceutical Companies engaged in research and in the manufacture of medicinal products for human use, while investing massive resources to develop innovatory medicines especially for complex pathologies.
The research, covering 20 diseases, such as Alzheimer, arthritis, asthma, cardiovascular diseases, depression, diabetes, epilepsy, hepatitis C, HIV, multiple sclerosis, tumours and others, has shown that, despite the existence of effective drugs, available in principle to all European patients, not everyone receives sufficient therapies. In some cases, patients are not treated at all, in others they only receive outdated medicines (which are less effective and have more severe side effects), while prescribed doses may be too low to produce any effects.
All this depends on various factors, the chief one being of a bureaucratic nature; however, the survey conducted by Prof. Oliver Schoffski also reveals causes linked to the marketing and prescription of medicinal products. Various studies conducted by the European Union, by the European Federation of Pharmaceutical Industries and Associations (EFPIA) and by Europe Economics (an independent consulting firm) show that, in addition to the very long experimental period taken to get to produce a drug, the time required for it to actually reach the market, even after the grant of a community authorisation, differs significantly from one country to the other, owing to procedural and bureaucratic delays of different kinds, which can reach up to four years. Italy, despite the significant improvements achieved over the last few years, confirms this trend, often displaying slowdowns within the average delays reported in the E.U.
This can lead to actual discriminations among patients, depending on the country they live in. Indeed some patients may find it impossible to use an innovatory drug, which is more effective than those that are already on sale, because it is not yet available on the market as a result of bureaucratic hold-ups. As EFPIA remarks, this situation is in some cases made worse by the decision to apply restrictive notes to medical prescriptions for the refundability of medicines. But bureaucracy is not the only hindrance to the actual therapeutic employment of innovatory medicines; very often poor knowledge of the new means by medical staff or the difficulty to access specialised centres for the diagnosis and treatment of the pathology in question facilitate the presence of a great number of cases of inadequate or wrong diagnosis, as shown and documented in the report prepared by the Health Management expert from Nuremberg University who illustrated in Brussels, on 21 January 2003, the research he had carried out in 15 European countries. We then have the incautious political measures relating to healthcare prices and budgets, which markedly contribute to an actual discrimination of patients, by hindering a proper circulation of medicines throughout the European Community.
A more precise analysis of available data shows that patients are discriminated depending on the country they live in, since often they cannot benefit from the same availability of medicines capable of preventing or treating certain diseases. In this regard, it should also be said that, usually, physicians tend not to prescribe drugs which are not covered by the NHS.
The situation varies, depending on the therapeutic indications, which lead to further discriminations in connection with the disease patients suffer from in a specific country; this chiefly happens when, like in Italy for instance, the member state imposes specific reimbursement conditions, by selecting certain categories of drugs subject to reimbursement and excluding others, or by imposing restrictive notes on prescriptions for reimbursement purposes.
Quite clearly, this discrimination is against the patients’ fundamental right, which basically consists of being guaranteed the same quality of treatment as individuals suffering from the same pathology but requiring different medicines. Unfortunately, in Europe, the problem also affects the healthcare field, and the survey carried out by Prof. Schoffski has explicitly shown that the supply of medical treatment and of innovatory medicines to patients differs significantly in the various countries of the Community. Hopefully, therefore, we shall soon witness the constitution of a single Authority in Healthcare, that may set itself as its goal the abolishment of existing gaps between actual therapeutic treatment offered to the patients and the ideal treatment they should be granted based on the scientific knowledge that has already been documented and accepted within the European Community, but whose enforcement is still in progress in the individual countries. The requirements of high quality medicine ought to receive a general acknowledgement that may make it possible to place at the disposal of each patient the most effective means for treatment as quickly as possible throughout Europe. Translated by Interpres sas
Amedeo Pavone
