OBJECTIVES: With constant incentives for health care payers to contain their pharmaceutical budgets, modelling policy decision impact become critical. The objective of this project was to test various policy decisions on pharmaceutical budget (developed for the European Commission for the project “EU Pharmaceutical expenditure forecast” -http://ec.europa.eu/health/healthcare/key_documents/index_en.htm) METHODS: We built a model to assess policy scenarios impact on pharmaceuticals reference forecast  for seven EU Member States (France, the United Kingdom, Germany, Poland, Portugal, Greece and Hungary). The following scenarios were tested: expanding UK policies to EU, time to market access, reimbursement rate , generic price and penetration,  distribution chain of biosimilars. RESULTS: Applying the UK policy would incur dramatic savings for Germany (10 times the reference forecast). France and Portugal would also enjoy substantial additional savings under this scenario (2 and 4 times the reference forecast respectively). Delaying time to market is very powerful to reduce the pharmaceuticals expenditure. While applying the EU transparency directive (6 month-process for pricing and reimbursement), it would increase budget for all countries (from 1.1 to 4 times the reference forecast), except in Germany  (additional savings). Decreasing price of generic and boosting the penetration rate, associated to distribution of biosimilar through hospital channel is a powerful way to reduce pharmaceuticals expenditure.In comparison, reimbursement rate has a modest impact. CONCLUSIONS: The most important leverages that were identified by the model on the pharmaceutical budget are driven by generic and biosimilar prices penetration rate and distribution.  Reducing, even slightly, the prices of generics will have a major impact while reimbursement rate has less impact. Time to access for innovative products is an effective  leverage used by some countries for delaying the bill.