AUSTRIA
From the survey • The vast majority of the respondents reported encountering no difficulties obtaining their medicines and medical devices. • Education or information about treatment was received almost universally among surveyed people with diabetes but was far less frequent among their relatives. • Although some fees apply to medicines, this was not identified as a major issue by respondents or the Austrian Diabetes Association.
Healthcare expenditure profile (2011)2
Key background information: country health system
24%
Total health expenditure per capita: USD 5,280.40 Proportion of government expenditure on health: 15.9%
Public expenditure Private expenditure Out-of-pocket expenditure represents 67% of private spending on health.
76%
Health system overview
- Austria’s mandatory health insurance system, administered by more than 20 health funds, covers the whole population.3 - The package of benefits is defined by law as well as through negotiations between the different stakeholders.3,7 Healthcare provision is the responsibility of each region.3,9 - Medicines and medical devices are supplied principally by private actors, according to the Federal Ministry of Health regulations – in line with EU regulations.3,9 A specialised agency ensures the application of these regulations.3,4,9 - A quality issues reporting system is in place6.
Diabetes prevalence (2011)1,6
Key diabetes data
IDF Atlas
National Data
9.1% of 20-79 year-olds
Austrian Diabetes Report 2011: 8% to 9%
Diabetes care procedure
- Prescriptions are provided mainly by GPs.6 - Physicians and diabetes nurses are the principal points of diabetes information and advice.6 - Diabetes products are dispensed mostly at pharmacies. A reduced number of products may also be distributed at outpatient clinics or hospitals.5,6
Presence of products at national level
• At least one product from each of the categories surveyed appeared to be authorised for sale and effectively present in the country.1,5,6
Availability
Guidelines, specific prescription criteria and patterns of use
• Austria has guidelines for diabetes care.1 • For medicines, prescription criteria are related to reimbursement classification: depending on the “box” into which medicines have been classified, these may be prescribed without additional criteria, for specific indications only, or require ex-ante approval from health funds.4 o Some newer oral and injectable medications require authorisation prior to prescription and can be prescribed only to people who are failing to achieve good glycaemic control with other therapies.6 o Some long-acting insulin analogues can be prescribed only to certain people with diabetes (for example, people with type 2 diabetes with nocturnal hypoglycaemia).2 • The prescription of medical devices is also affected by reimbursement: o Pens are the most widely used insulin injection devices.5 Pumps are mainly prescribed to: people with type 1 diabetes;5,6 women during pregnancy; people with type 2 diabetes who do not achieve good glycaemic control with conventional insulin therapy; people with certain complications, severe hypoglycaemia or hypoglycaemia unawareness.6 o Regarding blood glucose test strips for people who are not on insulin or oral medications that have associated risks of hypoglycaemia, the prescriber is obliged to justify their prescription.6 • According to the Austrian Diabetes Association,6 these constraints on prescription represent the key restraining issue in people’s access to medical devices, and especially to new medicines. o This Association considers that the “box” system applied to medicines significantly delays access to new medications. It involves lengthy procedures until the medicine is effectively available to people and tight prescription criteria apply for a prolonged period.6
46