Table 3.

Principal measures used to evaluate changes in prescribing efficiency for both the PPIs and statins during the study years as well as categorize countries.

Objective	Measure	Efficiency criteria/comment
Assessment of overall prescribing efficiency	The increase in utilization rates versus the increase in reimbursed expenditure over time*	Three efficiency criteria    No efficiency – rate of increase in expenditure exceeds utilization    Efficient countries – rate of increase in utilization more than    double the rate of increase in expenditure    Considerable efficiency – reimbursed expenditure decreasing over    time despite increasing utilization. In the case of statins this also    includes considerably increased utilization (over 350% during the    study period) with only a limited increase in expenditure (20% or less)
Extent of potential savings from increasing prescribing efficiency	Overall utilization in 2007 (DDD/TID) compared with overall expenditure (€/1000 inhabitants/year), with both measures adjusted for population sizes	Data treated with caution as different co-payment levels for the PPIs and statins (Table A1 of Appendix) in addition to any co-payment for the package

*Generic PPIs and statins were often available in Central and Eastern European countries before 2001 distorting the figures in reality. The Republic of Ireland will not be included when assessing potential savings (Figures 3 and 4) as the GMS population has greater morbidity than the general population reflected in appreciably higher utilization of pharmaceuticals.