Literature review on entry of medicines in European Small Markets

Objective: To carry out a systematic literature review to identify elements that either hinder or facilitate the entry of medicines in European countries characterized by small populations or low income levels.

Methodology: We searched MedLine, Web pages, OECD Publications and PPRI reports, using key words and free terminology. We included studies concerning the availability of medicines in European countries with Small Market. Two independent reviewers carried out the review process.

Results: The size of pharmaceutical markets appears as one of the obstacles to introducing new medicines in countries, rather than low purchasing power or lack of competition in certain therapeutic sectors. Requirements involving the translation and labelling of products can pose problems for small pharmaceutical companies. The literature also shows that patients with rare diseases sometimes suffer from the lack of an adequate supply of drugs.

Conclusion: There is a paucity of published evidence on the impact of availability of drugs in the small market. This review highlights the need for more studies to build an evidence base on the availability of medicines in countries with low incomes or small population.