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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Variable access to clopidogrel in a harmonized EU market.

Pieter Stolk1, Svetlana V Belitser, Hubert G M Leufkens

  • 1Utrecht Institute for Pharmaceutical Sciences, Utrecht, The Netherlands.

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|May 21, 2008
PubMed
Summary

National reimbursement policies significantly impact clopidogrel prescribing across European Union member states. Despite central registration, varying national strategies create disparities in clopidogrel access and utilization.

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Area of Science:

  • Health Economics
  • Pharmaceutical Policy
  • Cardiovascular Medicine

Background:

  • Clopidogrel, a key antiplatelet medication, has central European Union (EU) registration.
  • National coverage and reimbursement strategies influence drug access and clinical practice.

Purpose of the Study:

  • To assess the impact of reimbursement policy changes on clopidogrel prescribing in EU member states.
  • To identify factors associated with clopidogrel prescribing levels, including policy specifics, health system characteristics, and cardiovascular care delivery.

Main Methods:

  • Data collected from nine EU countries (Austria, Belgium, Denmark, Germany, Hungary, Portugal, Slovenia, The Netherlands, UK).
  • Utilization measured in defined daily doses (DDDs)/1000 persons/day.
  • Segmented linear regression used to analyze policy influence on utilization.

Main Results:

  • Significant variation in clopidogrel prescribing rates observed across countries (2.76 to 6.83 DDDs/1000 persons/day).
  • Six countries imposed therapeutic indication restrictions on clopidogrel use.
  • Health system characteristics did not explain the observed prescribing variations.

Conclusions:

  • A discrepancy exists between a harmonized EU pharmaceutical market and national-level realities.
  • National policy measures significantly shape the clinical role of centrally registered drugs like clopidogrel.