Table 1.

Principal measures used to evaluate changes in prescribing efficiency for both the PPIs and statins during the study years as well as categorize countries (Godman et al., 2011a).

Objective	Measure	Efficiency criteria/comment
Assessment of overall prescribing efficiency	The increase in utilization rates vs. the increase in reimbursed expenditure over time*	3 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
		Very efficient countries—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/DID) 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 in addition to any co-payment for the package

^*NB Generic PPIs and statins were often available in Central and Eastern European countries before 2001 influencing the figures. The figures for the Republic of Ireland are distorted by the fact that the GMS population has a greater morbidity than the general population reflected in appreciably higher utilization of pharmaceuticals.