Why pharmacoeconomic policy should be transnational

There is an inherent disconnect between the global-level endeavor of innovating pharmacotherapeutics and the (still) national-level of decision-making about access to innovation. In this paper, we argue that rational pharmacoeconomic policy should not be at the national, neither at the supranational, but at the transnational level: based on the relative similarity of countries in terms of their per capita health care spending. The 2010 OECD Health database, complemented as necessary with secondary data sources to substitute for missing data, was used to compile an analysis sample of all but two OECD countries (Chile and Greece) with data through 2007. We first established the overall divergence of, and heterogeneity among, countries in terms of 2007 per capita total and pharmaceutical health care spending as relative proxies of pharmacoeconomic policy. Next, we applied cluster analytic methods to identify OECD member countries that are similar in terms of 2007 per capita pharmaceutical and total health care expenditures, and the ratio of both.