Health Database Landscape in European Countries: An In-Depth Analysis

OBJECTIVES: Given the variety of health databases in Europe, coupled with heterogenous access pathways and data available, the objective of this study was to identify main European healthcare databases and assess their potential uses in market access.

METHODS: A comprehensive review of health databases in Europe (France, UK, Germany, Italy, Spain, Denmark, Sweden and Norway) was carried out by examining sources such as PubMed, Embase and Google Scholar. For each country, were examined data content, data owner and type of access.

RESULTS: The review demonstrated significant diversity in the type of databases available across European countries, as well as the their access. Overall, 14 databases of interest were selected and further investigated. It corresponded to around 2 databases per country. Nordic countries (Norway, Sweden and Denmark) were the ones with the highest rate of registries, requiring formal requests to access and highly relevant as they cover almost the entire population. Western Europe databases focused on medico-administrative data featuring anonymized individual data akin to French datasets (e.g., costs, hospital admissions, outpatient data). Access is managed through online application processes, involving various data providers and platforms. Data providers include governmental health agencies, research institutions, and private sector entities. France showed strong potential regarding data available in open access. Indeed, large datasets including drugs consumptions, hospital stays, are available and can thus be used in health technology assessment dossiers.

CONCLUSIONS: This non-exhaustive review demonstrated the diversity of European databases which could be used for real world evidence to answer HTA requirements. In this context, the European Health Data Space (EHDS) will harmonize the databases across Europe and maximize their potential for patients, researchers, innovators, and regulators.