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This article compares the pharmaceutical pricing policies employed by public and private insurers in the United States with seven price and spending control strategies employed in the United Kingdom, France, and Germany. Differences between American and European policies explain why American pharmaceutical prices and per capita spending are higher than in European nations. The article then analyzes two recent bills as examples of significant American reform ideas--H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act (introduced in 2019) and the Build Back Better Act (BBBA, introduced in 2021)--and compares them with European cost control strategies. Key drug price provisions of the BBBA were incorporated into the recently enacted Inflation Reduction Act (IRA). H.R. 3 would have used an international (mostly European) price index to cap U.S. prices, the BBBA would cap Medicare prices at a discount from average U.S. market prices. Neither bill would employ the key cost control strategies that European nations do. Both bills would have significantly less impact on prices than legislation that employs European-style cost controls. This article proposes steps that Congress could take in line with European strategies to lower purchase prices and costs for patients. These measures would have to overcome political obstacles that currently stymie reform. [ABSTRACT FROM AUTHOR]

Background Schmallenberg virus (SBV) was first detected in November 2011 in Germany and then rapidly spread throughout Europe. In beef suckler farms, clinical signs are mainly associated with reproductive disorders, particularly in late gestation, and intransient and non-specific symptoms, namely diarrhea, inappetence and fever. The objectives of this study were to develop models that simulate the production of different beef suckler systems in the United Kingdom (UK) and France and to use these models to estimate, through partial budget analyses, the farm-level economic cost of SBV under two disease impact scenarios, namely high and low impact. The probability for a farm to be in the high or low scenario depends, among other, on the high, low or nil vectorial activity for a given period and location and on the period(s) of sensitivity of the animals to the disease. Results Under the high impact scenario, the estimated SBV impact ranged from 26€ to 43€ per cow per year in France and from 29€ to 36€ per cow per year in the UK. It was approximately half of this amount in the low impact scenario. These financial impacts represent 5 to 16% of the gross margin, depending on the country, impact scenario and livestock system considered. Most of the SBV impact originates from the costs of the steers and heifers not produced. Differences identified between the systems studied mainly stem from differences among the value of the steers or heifers sold: SBV impact is higher for British autumn calving systems compared to spring calving, and for French farms with calving and fattening activities compared to farms with only a single, annual calving activity. Conclusions This study shows the usefulness of integrated production and economic models to accurately evaluate the costs of diseases and understand which factors have major impacts in the different systems. The models stand as a useful basis for animal health professionals when considering alternative disease control measures. They are also a farm accounting tool for estimating disease impact on differing production practices, which creates the necessary basis for cost-effectiveness analysis of intervention strategies, such as vaccination. [ABSTRACT FROM AUTHOR]

This article explores the impact European Union (EU) integration has had on methods and processes of budgeting in France and Britain from 1970 to 1995. It assesses whether convergence of budgetary institutions occurs and, if so, whether it is promoted by an obligation of compliance or by an hybridization effect. Compliance refers to changes in national budgetary institutions made compulsory by membership in the EU. Hybridization emphasizes that national and EU budgetary processes are increasingly interwoven and indivisible. Public budgeting is no longer purely national because part of the decision-making on national expenditure is made at the EU level and because the national budget is closely linked to the EU budget in financial and policy terms. Based on an institutional analysis, combined with elite interviewing, the article suggests that hybridization is a significant factor contributing to a convergence of budgetary practices in Britain and France. Underlying the argument is the fact that an increasingly important function of departmental actors involves negotiating with their EU counterparts at the EU level, in addition to the conventional budgetary game at the domestic level. Regarding compliance, there is an influence as testified by significant formal institutional convergence. However, compliance seems a less effective factor in influencing convergence than hybridization because it conveys a "negative" approach to convergence, based on enforcement and sanctions. The article suggests that the convergence of administrative systems is promoted by the growing similarity of administrative practices more than by the harmonization of rules. [ABSTRACT FROM AUTHOR]