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Table 2 Parameters of the EPR methodology in the studied EPR-applying countries, 2015

From: Impact of changes in the methodology of external price referencing on medicine prices: discrete-event simulation

Country Reference countriesa Benchmark price Consideration of discounts Weighting of price data Revision frequency (months)
Austria 26 [14] Average No No No revision
Belgium 27 [1] Average No No No revision
Bulgaria 17 [1] Minimum No No 6
Croatia 3 out of 5b [2] Average No No 12
Cyprus 4 out of 10b [1] Average No No 12
Czech Republic 19 [3] Average of 3 lowest No No 36
Estonia 3 [1] Minimum No No 12
Finland 29 [1] Average No No 60
France 4 [1] Average No No 60
Germany 15 [1] Average Provided for in legislationc Provided for in legislationc No revision
Greece 26 [3] Average of 3 lowest No No 3
Hungary 31 [3] Minimum No No No revision
Iceland 4 [3] Average No No 24
Ireland 9 [1] Average No No 36
Italy 25d [1] Minimum No No 24
Latvia 7 [1] Third lowest price No No 24
Lithuania 8 [1] Average No No 12
Luxembourg 1 [1] Minimum No No 12
Malta 12 [3] Average No No 18
Netherlands 4 [2] Average No No 6
Norway 9 [1] Average of 3 lowest No No 12
Poland 31 [1] Average No No 24
Portugal 3 [1] Average No No 12
Romania 12 [1] Minimum No No 60
Slovakia 27 [1] Average of 3 lowest No No 6
Slovenia 3 [1] Minimum No No 6
Spain 18e [1] Minimum No No 12
Switzerland 6 [1] Average No No 36
  1. aIn bracket the number of minimum reference countries that are required in legislation to determine an EPR benchmark price
  2. b3 (Croatia) and 4 (Cyprus) defined reference countries, respectively, out of a pool of 5 (Croatia) and 10 (Cyprus) reference countries, as data of alternative reference countries are considered in the case of non-availability of data in the primary 3 or 4 reference countries
  3. cAccording to legislation, Germany can consider mandatory and confidential discounts of prices in other countries, but this is not applied in practice. Furthermore, Germany has the legal mandate to weight the price data by estimated yearly turnover of the medicine (information to be provided by the pharmaceutical company) and by purchasing power parities (PPP). As both discounts as well as weighting are no common practice in the EPR in Germany, this was not considered in the base case simulations
  4. dCountries with price data included in the Euripid database
  5. eEurozone countries