Since 1997 WHO has provided sustained medicines support, including courses on pharmaco-economics, assistance for the Baltic Medicines Conferences of 1997 and 2001, and technical input for developing reimbursement systems, to Estonia, Latvia and Lithuania. As a result, these three Baltic countries succeeded in bringing together the expertise and necessary political support for developing and adopting a common guideline on pharmaco-economic evaluation of new medicines. The Ministry of Welfare of the Republic of Latvia, the Ministry of Social Affairs of Estonia and the Ministry of Health of the Republic of Lithuania signed a Memorandum of Understanding in September 2002 agreeing to:

• strengthen co-operation between institutions working on pricing and reimbursement of pharmaceuticals and pharmaco-economic analyses at national level

• use a common methodology for assessing costs and cost-effectiveness of pharmaceuticals in order to support decision-making on resource allocation for health care

• exchange information on prices and pricing of pharmaceuticals

• exchange information on legislative changes relating to pricing and reimbursement of pharmaceuticals, and application of cost-containment measures.

The three countries will now be able to build on each other's assessment of applications for reimbursement, reducing duplication and leading to more informed and consistent decision-making on reimbursement.