Background High cost medicines challenge the solidarity based funding of healthcare systems in general and the medicine budgets of hospitals in particular. However, little is known about the prices of such medicines.

Purpose The study aimed to survey and compare the prices of high cost medicines used in hospitals in European countries.

Material and methods We selected 15 medicines from the hospital sector that accounted for high expenditure for public payers in Austria in 2012, based on data provided by the Viennese Hospital Association. Ex-factory prices were surveyed as April 2013 for 16 European countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, The Netherlands, Portugal, Sweden, Slovakia, Spain and the UK). Prices were compared per unit (ie, per vial). Prices for non-Euro countries were converted into Euros based on the monthly exchange rate of March 2013, as indicated by the European Central Bank.

Results 6 of the selected medicines (human normal immunoglobulin, bortezomib, pemetrexed, bevacizumab, rituximab and ipilimumab) had a pack price (median of the 16 countries surveyed) of more than €1000; ipilimumab with a median price of €17 000. The comparison showed that Sweden had most frequently unit ex-factory prices in the fourth (ie, highest) quartile (in 83% of the 15 medicines), followed by Germany (73%) and Finland (53%). Countries that most frequently had prices in the first (ie, lowest) quartile were Hungary (90% of medicines), Greece (85%) and the UK (67%). In 74% of the medicines in the sample, Greek prices were the lowest of the analysed countries. The range between the price in the highest priced country and the lowest priced country ranged between 25% (ipilimumab) and 132% (pemetrexed).

Conclusion Medicine prices varied between European countries, with Sweden and Germany at the higher end and Greece and Hungary at the lower end. The study confirmed the hypothesis of high prices for hospital medicines. As these high prices contribute to high expenditure for hospitals, this indicates a need for change in pricing policies. Otherwise these medicines will use a substantial portion of budgets at the expense of other needed investments.

References and/or Acknowledgements The study was financed by the Austrian Federal Ministry of Health.

No conflict of interest.