Barriers to access and use of high cost medicines: A review

Barriers to access HCMs are inter-related. These barriers are also relevant for other medicines but are escalated in the case of HCMs. Overall, healthcare systems are facing barriers related to high out-of-pocket cost for patients and/or barriers regarding the decision-making process and the effects of reimbursement decisions (i.e., restricted, delayed or denied access, particularly the latter for socialized systems with a universal coverage scheme). Inadequate access to HCMs may lead to subsequent use of unnecessary medical treatments. Barriers to access HCMs can also lead to treatment disparities between patients who can overcome these barriers and those who cannot. Improvements in the decision-making process can increase acceptance of the need to prioritize access to HCMs.