Rising drug prices are a political issue. Alone, the expenditure for novel cancer agents and immunosuppressive agents grew, according to the Helsana-drug report by more than 14 percent. Their share of total medicines expenditure has exceeded the threshold of 25 percent.
In Switzerland, the Federal office for health (BAG) sets the price of drugs. The price mechanism is now under increasing criticism. Health economists like Guido Klaus von Helsana, the non-governmental organisation Public Eye or Price watchdog Stefan Meierhans call for reforms, because the BAG was compared to the pharmaceutical industry in a weaker Position. "Pharmaceutical companies should have less Power in determining the prices," says, for example, Price watchdog Stefan Meierhans.
On paper, the price mechanism sounds simple: The price for the medium, which must reimburse the health insurance companies, depends on the prices which are paid abroad for the relevant funds. The second factor is the therapeutic cross-comparison, so what is the treatment with comparable products cost and how high the added value of the new Agent is.
The office without the knowledge
The Problem: The BAG has no idea of how much, for example, a health insurer pays in Germany for a new drug actually. Although there are official list prices, which are public. But the pays no one, the industry agreed discounts. "No one knows the net prices of the other", confirms the BAG. "Just for high-priced medicines, it is a fact that the international published rates will not be reimbursed."
Therefore, Helsana expert Klaus says: "The foreign prices with the discounts granted into the Void, it is a discontinued model." Since no country knows the true prices of the other, could play in the pharmaceutical industry in the countries off against each other. The result is that the official list prices are only the shop window prices. The grants to the BAG.
Work in the models, really?
The Problem: The office with the discount game. Recently, the "Rundschau" in a post, like the BAG and the Roche group had quarreled for many years, the price for the cancer drug, Perjeta. The "Rundschau" has this newspaper documents. Actually, discounts on the Swiss price system for drugs has not provided. According to the documents, there are now 21 such models with a so-called reimbursement.
However, the BAG of such models speaks "only in exceptional cases". So for example for combination therapies, where two or more expensive cancer agents are used, for example, Roche's best seller Herceptin and Perjeta. "The discounts granted are pure back-room deals, in which the BAG is on the contrary to come of the industry rely," says, however, Guido Klaus von Helsana. The BAG I have no legal power to request such discounts or enforce.
It was "for the implementation of pricing models in the speciality list of mutually agreed solutions with the pharmaceutical companies," says the BAG. However, it would keep the industry at the agreed discounts, the models would work.
gateway for price increase
No wonder: Because of the high Swiss list prices, industry profits, such as price supervisor Meier Hans warns: "The pharmaceutical industry wants a high Swiss "window price", as also in the foreign price comparisons can be carried out, and a high Swiss price is, therefore, advantageous for you."
The BAG refers in this point to the fact that the office is doing its discounts to the public. Nevertheless, the non-governmental organization of the Public Eye, is critical of the discount models because of their lack of transparency. This be increases a a gateway for hidden price. Thus, the current net price of Perjeta with 2851.77 Swiss francs was around 30 percent higher than in 2013, and this, although the official list price had fallen to about 12 percent. The reason is a substantial decline in the repayment amount is "" the Public Eye, determined.
The debate about the Reform of the system runs: price supervisor Meier, Hans calls the BAG "is increasingly working with foreign authorities, in order to strengthen its negotiating power". In addition, health insurers in the case of drugs, prices, request, and recourse should be to get right. But, as long as the legal price will remain the rules in the core unchanged, would bring, according to the Helsana expert Klaus is such a right of action alone is of little use. He wants to change the entire System. "Among other things, the price would need to be set also with regard to the affordability for the System," he suggests. A relevant initiative in this direction, the Council of States has rejected but recently.
The pharmaceutical industry speaks of a "best price system". Discount solutions would undermine the current System, of which "cannot be said", explains the Association Interpharma. In the case of drugs that could be used for several diseases, as well as in combination therapies, the System push "to its limits". Therefore, a "flexibility of the price system is necessary, which in the individual case pricing and reimbursement models," inter Pharma.
Created: 12.02.2019, 10:22 PM