Cost containment measures including price and reimbursement cuts are putting pharmaceutical manufactures under increased pressure and tougher market conditions are evident in Central and Eastern Europe. The current reimbursement environment in many CEE countries continues to pose challenges for all pharma market players, including producers and distributors of medicinal products alike.
Despite financial constraints, national governments and healthcare authorities are striving to preserve the same levels of accessibility to innovative drugs. In Slovenia, ZZZS, the Health Insurance Institute of Slovenia, is expected to make available a total of EUR 444.5m for drugs, medical aids and vaccines in the course of 2019 which is 7% more than in 2018 Its budget for 2019 envisages EUR 2.14bn going for healthcare services representing a 5.6 per cent increase versus 2018
In Hungary, the inclusion of innovative medicines on the reimbursement list requires considerable improvement given bureaucratic hurdles and lengthy complicated inclusion processes compared to other CEE counterparts. The slow pace of the inclusion process is reflected in a decreasing number of subsidised new medicinal products in Hungary. While since 2016 only 48 new, mostly innovative medicines have become available to Hungarian patients, in Bulgaria and Slovakia 71 and 69 products were added on the reimbursement lists.
To combat these challenges AIPM, the Association of Innovative Pharmaceutical Manufacturers is calling for the establishment of a transparent and predictable decision making mechanism and the provision of adequate state resources to improve access to new drugs for Hungarian patients.
In Latvia, the government and the Ministry of Health are joining efforts to eliminate a ‘two-basket’ healthcare system and replace it with a unified structure for healthcare services. One of the key reform areas is an adoption of a small compulsory fee to ensure that as many people as possible can join the healthcare insurance system. Whilst conceptual at this stage, the changes to the state health insurance system together with tax reform review are due to be implemented in 2021.
The efforts to improve access to healthcare services and medicines in Latvia go beyond the healthcare reforms and include the endeavours of the national health authorities to boost competition within the pharmaceutical supply chain. At present Latvia’s pharma market is highly concentrated and distribution of medicines is controlled by a handful of large players. Lack of competition leads to distortion of prices in the multi-level cooperation between manufacturers,wholesale traders, pharmacy networks, hospitals, doctors and patients. Medicines are divided into different groups, each with their own price-forming principles.
The Latvian healthcare authorities have set up a working group to address the existing monopoly within the pharma supply chain and eliminate the obstacles which hinder the development of a fair competition within the industry. The ultimate objective is to achieve lower drug prices and improve accessibility to medicines for patients in Latvia.
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