ORGANIZATION: The Pharmaceutical Benefits Board in Sweden (LFN); Problem or Issue Addressed: In Sweden, the Pharmaceutical Benefits Board (LFN) was instituted in 2002 with the purpose of contributing to a rational and cost-effective use of pharmaceuticals. The Board's assignment is to systematically and in accordance with national prioritization guidelines decide which pharmaceuticals should be reimbursed. Societal cost-effectiveness is a key decision parameter. One task of the LFN is to review the subsidy status of all products (~3 000 products) that were already in the pharmaceutical benefits when the Board was instituted. All the drugs used for treating asthma, COPD and coughs (43 products in total)were assessed to see whether they still merited reimbursement. GOALS: The primary purpose of the review of these products is to inform the Board's decisions on subsidy status for the pharmaceuticals used within the therapeutic area of asthma, COPD and coughs. The secondary purpose is to help other decision makers in Swedish health care to rationally and cost-effectively use pharmaceuticals in the treatment of these diseases. OUTCOMES ITEMS USED IN THE DECISION: The scientific literature was searched for systematic reviews and meta-analyses of effectiveness and efficacy data, evidence on the humanistic burden of disease, as well as for health economic evaluations. IMPLEMENTATION STRATEGY: All currently reimbursed drugs with ATC-codes R03 and R05 were included in the review. A project team consisting of a pharmacist, a health economist and a legal advisor led the investigation. 3 external clinical experts were also attached to the project group. These experts were recruited based on nominations from stakeholders, both from the healthcare system and patient organizations. Companies marketing a product included in a review were asked to submit documentation about which studies best support the effectiveness and cost-effectiveness of their product. Before the report was published it was sent out for review by the stakeholders involved. RESULTS: Of the 43 products reviewed, 34 retained their reimbursement status. Eight products were removed from reimbursement while limited reimbursement was granted for one medicine. Of these nine medicines, five are cough medicines and four are medicines against asthma and/or COPD. The four asthma/COPD products were removed primarily because they were not judged to be cost-effective. The medicines against cough were removed from reimbursement due to the severity of the disease being low.