23 January 2018 - Competition is a subject always open to debate in health care, and pharmaceuticals are no exception, with the only clear difference from other ‘markets’ (e.g. hospital services) being that the supply side is private industry, worldwide.

Although the vast majority of pharmaceutical companies are multinationals nowadays and so many national differences have been smoothed, the presence of an important national pharmaceutical industry has historically affected the national policies of the major European countries. 

For instance, the positive contribution to domestic economies (in terms of employment and trade export) favoured a positive attitude towards the pharmaceutical industry in northern countries like Germany and the UK. In contrast, the chronic trade deficits in southern nations like Italy and Spain favoured tighter pricing and reimbursement schemes, although even these were not necessarily effective in containing domestic expenses boosted by aggressive pharmaceutical marketing in these countries.

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