Background: The demand for new medicines is constantly rising—and alongside that demand are increasing prices on patented pharmaceuticals. Significant disparities regarding access to medicines are emerging across the European Union (EU). However, only limited data is available on the price difference of medicines used in hospitals across the EU. The aim of this paper is to assess access to patented, high-priced medicines used in hospitals in different EU Member States.

Methods: Four EU Member States (Austria, France, Spain and Latvia) were selected for study. Hospital prices of five medicines in three key therapeutic areas (cancer, rheumatic diseases and hepatitis C) were collected. Official list prices for hospital procurement were compared and unit prices were related to annual gross domestic product (GDP) per capita. Additionally, 14 semi-structured interviews with key informants were conducted to gather information on access to the medicines for the inpatient sector.

Results: The hospital prices of medicines are disconnected from the GDP per capita of a country. Latvia and Spain have higher prices for the studied medicines compared to Austria and France, despite having lower GDPs per capita. Latvia has the lowest annual GDP per capita, but the price of the selected medicines in Latvia is the highest of all four countries.

Conclusions and Recommendations: This study presents evidence of price inequalities of high-priced medicines in the hospital sector in Europe. Several policy recommendations are presented to address this challenge.

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