HC Statistics International Health Care Systems Pharmaceuticals

Orphan medicine policies in 24 European countries

Drugs known as “orphan” drugs are those used to treat rare disease.  However, how “rare” is rare disease?  In Europe, a rare disease is one affecting 5 or fewer people per 10,000 residents.  In the U.S. this figure is less than one in every 1,500 residents.  Although each rare disease is–by definition–rare, about 350 million people worldwide (about the size of the entire U.S. population) suffer form a rare disease.  Because these diseases are rare, in most cases it would not be profitable for life sciences firms to invest R&D funds in the treatment of theses diseases.  To incentivize innovation to treat these diseases, many countries have specific policies to encourage the development of these treatments.

A recent paper by Sarnola et al. (2018) reviews the policies of different European countries surrounding orphan drugs used in outpatient care. They interviewed government authorities within the and included the following countries: Albania, Austria, Belarus, Bulgaria, the Czech Republic, Estonia, Finland, Germany, Hungary, Iceland, Italy, Latvia, Lithuania, Malta, the Netherlands, Norway, Poland, Russia, Slovakia, Slovenia, Spain, Sweden, Turkey and the United Kingdom.  Although the Europeans Medicines Agency determines whether a drug counts as an orphan status, access and reimbursement policies vary across countries and do not guarantee that the treatment will be fully covered.

Most of the countries had not implemented any special regulations or policies for assessing the reimbursement status (22/24) or pricing (20/24) of reimbursable orphan medicines used in outpatient care

Although a number of countries had special dispensations for orphan drugs, some countries also had additional restrictions to control costs.  For instance:

Cost-containment measures for expensive medicines in general were implemented for orphan medicines, too. In countries such as Finland, Hungary, Lithuania and Spain, the reimbursement of orphan medicines could be limited to defined clinical conditions, and Hungary and Russia required that the medicine was prescribed in a certain health care setting. Orphan medicines could also be subjected to price-volume agreements and confidential discounts. In Italy, on the other hand, marketing authorisation holders of orphan medicines were excluded from the payback arrangement.

The authors also looked at whether national governments made 10 recent orphan medicines available to their residents. They found significant variability in orphan medicine availability across countries.

The authors also found that “patients generally pay some of the costs when products are dispensed from community pharmacies, and receive products free of charge when they are dispensed from health care units.”

The study is a nice review of orphan drug policy across Europe.



  1. Hi,
    Thank you for sharing this wonderful article with us..Its really glad to know about this Orphan drug policies..This is really very inspiring to know that their is something that we can do for these people..and many congratulation to you for sharing this post on such a big platform..

  2. There are differences in the availability of orphan medicines between different European countries.Rare diseases are life-threatening or permanently disabling medical conditions, and they affect some 30 million people in Europe and more than 300,000 people in Finland alone. People suffering from a rare disease do not always have access to the medicines they need. Factors limiting the availability of orphan medicines include them not entering the markets or their financial burden on the patient or society being too high.
    that’s why we must encourage pharmaceutical companies to target orphan diseases

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