by Peter O'Donnell
BRUSSELS, Nov 16 (APM) - Drug firms facing uphill battles to win satisfactory pricing and reimbursement deals across Europe are likely to find things get no easier next year, to judge from the assessment of national budgets released on Wednesday by the European Commission.
The analyses of healthcare expenditure are broadly downbeat and urge further caution and prudence.
For Slovakia, the Commission's recommendations bear directly on medicines.
"Savings should be achieved through addressing spending areas," says the Commission of Slovakia's draft budget for 2017.
"Spending on pharmaceuticals, health aids and special health materials is expected to be curbed by tackling overconsumption of pharmaceuticals and price referencing of special medical aids and materials."
It also urges making savings through "better management of hospitals' processes and procurement", and lower outlays on radio-diagnostic and laboratory examinations.
The recommendations come from the so-called European Semester, an annual check agreed by EU member states in the throes of the financial crisis that began in 2007.
Governments using the euro are required to submit their draft budgetary plans for the following year to the Commission by October 15. The Commission then issues its guidance on how each member state should modify its spending plans so as to ensure fiscal stability.
Healthcare spending, as a major component of public expenditure in every member state, is a frequent target of adverse Commission comment, and this year is no exception.
A general Commission communication as part of the package released on Wednesday, the Annual Growth Survey 2017, warns all member states that "Driven by population ageing and technological developments, public expenditure on health care and long-term care is expected to increase significantly in the coming decades."
It insists that to keep health systems sustainable "further policy action will be needed".
The focus is increasingly on broader health policy, rather than the reliance on more traditional curative approaches. It favours prevention, reinforced social safety nets and active inclusion strategies.
The reforms the Commission calls for to boost public finances include efforts to increase cost-effectiveness, and making more effective use of public procurement in the provision of health services.
The Commission's detailed comments on the draft budgetary plans of euro area member states reflect the trend towards tighter controls on healthcare spending.
For Belgium, it says healthcare savings to curb the underlying trend of rising expenditure should represent the bulk of budgetary consolidation in 2017.
Ireland received a reminder that it had already received during the summer recommendations to "enhance the quality of expenditure, particularly by increasing cost-effectiveness of healthcare."
The Commission cast doubt on Spain's forecast of savings at regional level from the application of new pharmaceutical and healthcare spending rules in 2017. "There is no evidence of any region having agreed explicitly to apply that rule at the cut-off date of the forecast," says the analysis.
France is criticised for "the uncertain nature of planned savings on health care".
Austria's response to an earlier recommendation to ensure the sustainability of its healthcare system has been unsatisfactory, says the Commission. "The initiatives targeting the sustainability of the healthcare system appear limited in scope," it says. "No details are provided," and the moves made "do not appear sufficient to ensure the sustainability of the healthcare system".
In Portugal, "Overall, progress to ensure the long-term sustainability of the health sector has to date been limited".
Only in Finland are measures judged to be satisfactory in containing healthcare spending - satisfactory, that is, for accountants, if not for health-service suppliers.
Finland has complied with an earlier recommendation "to ensure timely adoption and implementation of the administrative reform with a view to better cost-effectiveness of health and social services," says the Commission. "The reform can be considered to be on track for the implementation as of 2019."
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