Preventative Medicine: How Information Can Modernize EU Healthcare

Publication Date: October 2004

Publisher: European Enterprise Institute

Author(s): Jeremiah Norris

Research Area: Health

Type: Report

Abstract:

There are major differences in the way that Direct-to Consumer Advertising (DTCA) operates in the United States (US) and throughout the European Union (EU). The central issue that both continue to face is the persistent difficulties in the financing and delivery of their health services. In the US, although the financing of these services is still less than 50 percent of national expenditures, the delivery is totally in its private sector.

However, in the EU, financing and delivery of health services remain largely a public enterprise. This diversity of finance and delivery between the two dramatically affects their approach to DTCA. Cost containment is common to both systems. However, in the EU, because of its reliance on public investment for health education and employment, the lion’s share of state budgets supports these two components. Unfortunately, population growth is inversely related to the expansion of health sector employment.

In the US, most health education is privately financed, as is employment and pension benefits. Growth rates in these two categories are matched by increases in a population that consumes more health services. Since the introduction of DTCA in the US during the mid 1980s, it has expanded rapidly. Early fears that it would lead to inappropriate pharmaceutical use and increased use of drug products have been dispelled by objective survey analyses, supported in part by the Food and Drug Administration (FDA) participation.

These same fears, though, have a persistent hold on EU policy-makers. They are caught in an intricate political web of trying to maintain funding for health manpower capacities in spite of the fact that physician/nurse to population ratios are falling precipitously. Any sign that they would cut funding for health manpower would signal an incipient intention to abandon the fundamental precepts of socialized medicine. To placate the public with a highly visible symbol of cost containment, at little cost to their political positions, public health authorities have singled out the pharmaceutical industries and their contemporary products. They have become the ‘poster boys’ of cost containment. But their ability to convince the public of success in this arena has worn thin.

An EU survey by Burson-Marsteller’s Brussels office revealed that compliance with the EU law prohibiting the advertisement of prescription medicines varies greatly among and between countries. In some countries, DTCA can be used if the prescription medicine is not on the state’s reimbursement list. In others, consumers are using the Internet to obtain information on them, buying these drugs after they are prescribed by a private physician.

In the end, EU law or no EU law, there will eventually be convergence between the US and EU systems, led by consumers’ rights for health information via the Internet.