By Jean Christou
THE introduction of the National Health Scheme (NHS) will likely bring drugs prices somewhere in between today’s private prices and what is achieved through government tenders, according to Richard Bergstrom, Director General of the European Federation of Pharmaceutical Industries and Associations (EFPIA).
Bergstrom was in Cyprus on Thursday for a meeting with Health Minister Philippos Patsalis. After the meeting, the minister announced a 10 per cent cut in drugs prices as of next year in line with a recent World Health Organisation (WHO) report that cited Cyprus as being among the most expensive countries in the world for medicines.
In an exclusive interview with the Sunday Mail, Bergstrom said that in principle, EFPIA does not think that governments should control prices for medicines that are not paid for by public money.
“Historically we have accepted these price controls for the private market in Cyprus, as Cyprus does not have enough public provision of medicines,” he said in a written Q&A. “The private market ‘compensates’ for the lack of public funding,” he added.
Bergstrom said he had wanted to meet Patsalis to hear about his reform plans.
“Cyprus is the only country in the European Union without universal health care. Therefore inequalities in access to medicines are bigger than in other countries,” he said.
He said that during the last two years no new medicines had been added in the public side of the Cyprus health care system. “And many of the other medicines are in practice not available either,” he said.
“People with money, now can buy medicines in the private market, but even for them it is not possible to carry the cost of the newest medicines. Cypriot patients have limited and unequal access to new medicines.”
He said the current reforms were an excellent opportunity for the country to “merge” the private market with the public market. Cyprus, he said, has the chance to build state-of-the-art system for medicines with clever co-payment, managed entry schemes for rapid introduction of new medicines, and for e-health.
“It is likely that prices will be somewhere in between today’s private prices, and what is achieved through government tenders. With introduction of reimbursement for all citizens, individual patients should overall pay less when they go to the pharmacy,” Bergstrom added.
Commenting on the WHO’s observation that Cyprus and the Czech Republic were the only EU member states that rely on foreign list prices to set domestic generic drug prices, the EFPIA chief said every country had a different model.
He said some countries use tenders and some require pharmacists to substitute to the cheapest version while others had a ‘formula’ for how prices should down after a patent has expired.
“The [Cyprus] government should continue to make sure that only high-quality generics are on the market,” said Bergstrom. “The co-payment model, that has to be developed for the new healthcare system, can also be defined in a way to encourage the use of generics,” he added.
The WHO report said Cypriots were leery of generics and that Cypriot generic drug prices were among the highest in Europe, coming in at around 80 per cent of branded names. By relying on the list prices instead of transaction prices in other countries, the Cypriot consumer was vastly overpaying for generic drugs, it said.
Coupled with the brand awareness issue, this had led physicians to potentially over-prescribe on-patent, expensive products with no fear of financial or non-financial penalties. “It is essential to break any financial relationships between physicians and pharmaceutical manufacturers or the pharmaceutical supply chain,” said the WHO report.
Recently, KEFEA, the Cyprus Association member of EFPIA, announced that pharmaceutical companies would be obliged to disclose transfers of value to healthcare professionals. Bergstrom said while it was important for pharmaceutical companies to collaborate with healthcare professionals and to educate them about new scientific findings, the system needed to be more transparent “so that people will not suspect anything inappropriate”.