Affiliations: Andalusian School of Public Health, Campus
Universitario de Cartuja, Cuesta del Observatorio, Granada, Spain | CIBER en epidemiología y salud puacute;blica
(CIBERESP), Spain | Departament de Teoria Econòmica, Universitat de
Barcelona, Barcelona, Spain
Note: [] Corresponding author: Antonio Olry de Labry Lima, Escuela
Andaluza de Salud Pública, Campus Universitario de Cartuja. Apartado de
correos 2070 (CP 18080) Granada, Spain. Tel.: +34 958 027 400; Fax: +34 958 027
503; E-mail: antonio.olrylabry.easp@juntadeandalucia.es
Abstract: 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.
