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Report/ The cost of medicine continues to rise, Europe's national budgets are being squeezed

2024-10-17 09:08:38Biznes SHKRUAR NGA REDAKSIA VOX

Report/ The cost of medicine continues to rise, Europe's national budgets

The European Social Insurance Platform (ESIP) report examined the levels of national public expenditure on medicines and focused on which therapeutics absorbed most of the expenditure. "We found that, surprisingly, spending on medicines continues to rise," said Benedetta Baldini, senior policy adviser at ESIP, presenting the results of the study which gathered data from 15 EU member states and Norway.

The study highlights a steady increase in pharmaceutical spending, both in hospitals and retail pharmacies, referred to as inpatient and outpatient spending, respectively. The main factor driving these increases is the increase in the cost of drugs, not the increase in the volume of prescriptions.

For example, in Austria, the number of drugs prescribed has not increased significantly, the study notes, while the cost per prescription in outpatient care has increased by 78% since 2013. Among the most expensive therapeutic areas, cancer drugs stand out, dominating expenses both outside and in the hospital.

In France, for example, oncology drugs account for 29% of outpatient pharmaceutical spending, with an annual growth rate of 11%. In the hospital setting, this number jumps dramatically, with 77% of hospital drug spending dedicated to cancer treatments.

Reimbursed prescription drugs, which are covered by national health insurers, represent only a fraction of overall health care spending. However, these rising costs are putting great pressure on national budgets, many of which have already been reduced by austerity measures in some countries.

These trends are placing heavy burdens on health care budgets, and thus on the people who pay for them. Outpatient pharmaceutical spending in Germany has increased by 22%, rising from €41 billion to €50 billion over the period 2019-2023. If this trend continues, the report warned that contributions to compulsory health insurance may not keep pace, potentially leading to higher contribution rates.

Another common trend across the countries surveyed is that increased spending is partly due to the introduction of new, often more expensive, therapies. Baldini from ESIP emphasized that these new and expensive treatments are taking a larger share of national pharmaceutical budgets. "We are seeing a shift in patients' preference for new products over older, well-known drugs," she said, pointing to Finland as a prime example of this trend.

While decisions on pharmaceutical marketing authorizations are based on efficacy and safety, reimbursement decisions on new drugs are usually made based on the relative effectiveness of a drug compared to existing treatments. This can lead to uncertainty, as some newly introduced drugs come with limited clinical trials, despite their higher prices.

Sophie Kelly, from France's national health insurance fund CNAM, warned that while patients benefit from early access to supposedly innovative treatments especially for serious diseases with unmet needs, there are risks. According to Kelly, approximately 21% of drugs granted early access in France were later deemed non-innovative by the country's national agency. Kelly also highlighted the rising costs of orphan drugs, which treat rare diseases that affect fewer than one in 2,000 people.

In France, the average annual growth rate of spending on orphan drugs was 20.5% between 2019 and 2022. "This is much higher than the growth rates for a global drug market," she said, hinting that these costs escalated pose a major challenge to overall pharmaceutical spending.


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