Pricing and reimbursement frameworks in Central Eastern Europe: a decision tool to support choices

Expert Rev Pharmacoecon Outcomes Res. 2015 Feb;15(1):145-55. doi: 10.1586/14737167.2014.898566. Epub 2014 Jun 26.


Aim: Given limited financial resources in the Central Eastern European (CEE) region, challenges in obtaining access to innovative medical technologies are formidable. The objective of this research was to develop a decision tree that supports decision makers and drug manufacturers from CEE region in their search for optimal innovative pricing and reimbursement scheme (IPRSs).

Methods: A systematic literature review was performed to search for published IPRSs, and then ten experts from the CEE region were interviewed to ascertain their opinions on these schemes.

Results: In total, 33 articles representing 46 unique IPRSs were analyzed. Based on our literature review and subsequent expert input, key decision nodes and branches of the decision tree were developed.

Conclusion: The results indicate that outcome-based schemes are better suited to deal with uncertainties surrounding cost effectiveness, while non-outcome-based schemes are more appropriate for pricing and budget impact challenges.

Keywords: Central Eastern European region; budget impact; cost effectiveness; innovative pricing and reimbursement schemes.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Decision Making
  • Decision Trees
  • Drug Industry / economics*
  • Europe, Eastern
  • Health Services Accessibility / economics*
  • Humans
  • Reimbursement Mechanisms / economics*