Abstract

The report is part of the Public Health Status and Forecast 2002 produced by the National Institute of Public Health and the Environment in the Netherlands. The report describes two complex parts of the Dutch Healthcare system: pharmaceuticals and medical devices, and the role of the stakeholders involved. Producers mainly determine the prices, despite regulation by the government and insurance companies. Pharmaceutical companies spend a lot of money to marketing. Marketing makes physicians less sensitive to price. Prescribers of medical devices often have insufficient information to prescribe the most efficient device. Besides the health status of the patient, the attitude and cultural background determine the use of pharmaceuticals. Medical need, participation, patient friendliness and social acceptance partly determine the use of medical devices. If policy remains unchanged, expenditure on pharmaceutical care will rise by 11% and expenditure on medical devices by 7% each year until 2006. This results from an increase in the number of prescriptions and a mean increase in price per prescription. These increases are due to demographic, socio-cultural developments and advances in medical technology. An analysis is given in the report.