Dutch top for healthcare despite low drug spending

By Ben Hirschler

LONDON (Reuters) - The Netherlands topped on Thursday a European survey ranking healthcare systems according to consumer value, despite having one of the continent’s lowest levels of spending on medicines.

Latvia came bottom of the 2008 Euro Health Consumer Index compiled by private Swedish company Health Consumer Powerhouse (HCP), which assesses a range of criteria including clinical outcomes, access to treatment, waiting times and patient rights.

The Dutch healthcare system has scored consistently well since the first league table was published four years ago, reflecting both the range and reach of its services.

“It is justified to say that the Dutch have the best healthcare system in Europe,” said HCP President Johan Hjertqvist.

“When the Obama healthcare policy team looks in Europe for inspiration it seems to be the right system to study.”

U.S. President-elect Barack Obama plans to overhaul the country’s healthcare system to extend health insurance to millions of Americans who currently lack it.

The next best performers were Denmark, Austria, Luxembourg, Sweden and Germany.

Britain ranked 13th out of a field of 31, behind France in 10th place but ahead of Italy and Spain, ranked 16th and 18th respectively.

Significantly, there was no obvious correlation between spending on medicines and superior healthcare provision.

France, for example, spends nearly twice as much on medicines per head of population as the Netherlands, according to 2005 figures compiled by Britain’s pharmaceuticals industry.

The discrepancy may reflect excessive use of older, less effective branded drugs in France compared to countries like Sweden and the Netherlands, which spend more wisely, according to HCP spokeswoman Kajsa Wilhelmsson.

“The Swedes get the medicines they really need but they don’t swallow the amount that the French do,” she said.

“It doesn’t prove they are mean about new medicines just because they don’t have a high spend. They might be using the money more efficiently on more modern rather than old drugs, or on generics.”

Across Europe, between 7 and 10 percent of national income is typically funnelled into healthcare but there are very different ways of organizing that expenditure.

HCP said countries taking a pluralistic approach and offering a multitude of insurance organizations tended to do better than systems that were dominated by a single healthcare provider.

(Eediting by John Stonestreet)

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