Europeanization of six Western Balkan countries’ pharmaceutical policies, a comparative analysis

Background

The Western Balkan countries aim to join the European Union and are at different stages in the European Integration process. All countries that aspire to join the EU have to adapt their public health policies (including pharmaceutical policies) to the EU requirements. We aimed to describe key elements of the Europeanization process influencing pharmaceutical policies in the Western Balkan countries in the past 19 years.

Methods

We conducted a cross-national conventional content analysis including all progress reports that six Western Balkan countries: Albania, Bosnia and Herzegovina, Croatia, Montenegro, North Macedonia and Serbia submitted to the European Union from 2005 to 2024 (109 reports). We considered Chapter 28 on “Consumer and health protection” and other chapters that contained the words “pharmacy”, “pharmaceutical sector” or “pharmaceutical policy.”

Results

The Western Balkan countries have signed international agreements such as a joint procurement agreement; have adopted the national legislation on pharmaceutical products and improved the laws on pharmaceutical activities; and have undertaken national strategies regarding antimicrobial resistance. Western Balkan countries tried to influence the price of the medicines through different national legislations regarding marketing authorization through national agencies, pricing and reimbursement policies, or other issues (as pharmacies, for example). Croatia was the first WB country that signed, as per the EU invitation of Western Balkan partners, the Joint Procurement Agreement to procure medical countermeasures in 2014. Bosnia and Herzegovina was the first country to adopt the Law on pharmaceutical activities in 2010.

Conclusions

Based on the current analysis, we find that the Europeanization process is positively influencing pharmaceutical policies in the Western Balkans.

Key messages

• Europeanization process is positively influencing pharmaceutical policies in the Western Balkans.

• The WB countries should implement more activities at the local level to make the populations aware of the importance of antibiotic use along with other medicines.