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Armed to generic prices and the margin of the pharmacist

Twenty percent could be saved in the Swiss health system, said the Federal Council, Alain Berset , as he presented his project "health 2020". That was a good six years, and the premiums for health insurance have gone up since.

The largest cost block, the hospitals, he has not committed to savings. Most of the hospitals belong to the cantons. The second-largest cost block, to the Doctors, he has intervened twice in the Tariff and adjustments and has, for the last Time with effect as of the beginning of 2018. However, the Doctors have compensated for the lower rates with more quantity of to a large extent.

Rigorous price reductions

Alain Berset has achieved in the field of medicines. He lowered the prices for patent-protected medicines rigorously. Every three years you will be reviewed by the Federal office of public health. So he reached at least a stabilization of the cost of medication. Failed it last April with the claim that parallel imports of these products from abroad.

In the summer of Berset, then those category of drugs, whose prices are still 50 percent higher than the same products abroad. There are active substances whose Patent has expired, and the then resulting generics that correspond to these Originals.

Alain Berset proposed last summer, first, a reference price system. Thus, only a certain price per generic would be accepted by the funds. The purchased drug would be more expensive, would have to pay the Patient the difference for yourself.

Secondly, the Federal Council wants to change the margin of the pharmacist, because the today is higher, the more expensive the drug is. The means for the pharmacist an incentive to sell a more expensive drug instead of a cheaper generic medicine. The Federal Council assumes that this is the reason why the share of generic medicines in Switzerland is lower than in most countries in Europe.

The Federal Council wishes to adjust the distribution so that the pharmacies have no incentive to sell more expensive drugs.

Both of these measures, the Federal Council sent last year in the consultation process. And both have been criticized fairly. Against the reference price system not only affected industry, but also the medical Association FMH, the Association of pharmacists Pharmasuisse and the hospital Association H plus fights. They fear that this System could lead to patients must change to a drug from a different manufacturer, no Supplement to pay. Also, the supply of drugs to see you in danger, because the manufacturer could pull out due to lower prices from the market. Even today, there are, for example, in the German generics market to a much greater supply and more competition.

On the other side of the price supervisor and the health insurers, who are demanding such a System for years. The price supervisor is hoping for savings of around 300 million Swiss francs. The health insurance Association Santésuisse estimates that the savings to 400 million Swiss francs, of the competition Association Curafutura to 800 million Swiss francs. Of the parties has expressed the SVP against the reference price system. The other parties on the Federal Council are, in principle, but they reject the two by the Federal Council of the proposed options, in part because they fear also disadvantages for the patient.

study estimates Savings deeper

Only after the completion of the consultation process – and, therefore, contrary to the recommendations of the competent state Secretariat for economic Affairs – the Federal Council published a regulatory impact assessment for the reference price system, what are the hopes of the proponents screwed down significantly follow. Although it was calculated in this study, a maximum cost saving of 310 to 480 million francs; then had to be immediately acknowledged that this was a static view, and that there would be additional costs, which would reduce the Savings.

in the Short term, can be expected nevertheless the savings in the three-digit million range, experiences abroad have shown, however, that the savings could disappear in the long term, especially if, instead of cheap generics of expensive original preparations would be made. Since the Swiss market is small and the reference price system only would apply if three or more products are available, depend a lot of how the manufacturer would conduct the study.

not happened exactly this, the Federal Council sent its second reform proposals in the consultation. He wants to adjust the compensation for the distribution to the pharmacists so that they have no incentive to sell more expensive drugs. To this end, he proposes two variants to reduce the sales share of 12 to 9 per cent, to increase the price per pack.

there is evidence to suggest that the market entry sales weaker generics are not worth the time.

This Reform will not be the parties on the Federal Council completely. The FDP does not find the proposals "ideal" and calls for a scheme that the cheaper drug had a competitive advantage. The SP is your own Federal Council, the Note "insufficient". The Reform does not solve the Problem. The SVP, the wrong incentives would be worse "even". Clearly the compensation in percent: the smaller, the less the pharmacist the benefit of expensive drugs. Behind the Scenes, the pharmacist works Association, according to reports on a model in which the distribution share to 3 per cent, would be reduced. In return, the pharmacies would earn more per pack and especially the cheap drugs are significantly more expensive.

however, There is another reason for the low share of generic medicines in Switzerland. It takes only twenty of the strongest sales drugs where the Patent has expired, their proportion is high, 73 percent. This suggests that the market entry is worth in revenue to weaker agents. The generic industry has complained for years about the high costs incurred in the examination and registration of medicines at Swissmedic and the Federal office for health. to increase

"the share of generics, we need to remove barriers," says national councillor and health specialist on Bea Heim (SP, SO). There is a growing Problem that in the case of drugs more and more often, delivery bottlenecks may occur. "Often, Doctors must switch their patients to the medication, which can lead to health problems," says home. FDP- health policy Philippe Nantermod (VS) adds the need to consider whether they could accept these for years in the use of the active compounds, the recognition by the EU as equivalent. (Editorial Tamedia)

Created: 29.01.2019, 18:25 PM

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