Livio Garattini1, Nicola Motterlini, Dante Cornago. 1. CESAV, Centre for Health Economics, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Via Camozzi 3, 24020 Ranica (BG), Italy. lgarattini@marionegri.it
Abstract
OBJECTIVES: To compare prices of in-patent active ingredients (AIs) in Europe at three levels (ex-factory prices, net distribution margins and third party payers' prices). METHODS: We compared the prices in seven EU countries (Belgium, France, Germany, Italy, the Netherlands, Spain and the UK) of the 20 in-patent AIs most sold on the Italian retail market in 2004, based on "sell in" sales data. We calculated the average ex-factory price per unit of each compound in each of the seven countries, weighted by the volumes of all reimbursable package sizes and strengths. We estimated net distribution margins according to the 2004 domestic regulations by deducting any type of mandatory discount. Finally, we added VAT to calculate "third party payer's prices". All prices were expressed in index numbers (Italy=100). RESULTS: Italy had the lowest average ex-factory prices, the Netherlands and particularly the UK had by far the lowest distribution margins, while Germany had by far the highest third party payers' prices. The Netherlands and particularly UK showed a steep decrease from ex-factory to third party payers' prices, while Belgium, Italy and Spain gave the opposite pattern. CONCLUSIONS: Our study suggests that public authorities can deal with drug prices both by strictly controlling ex-factory prices and by establishing appropriate distribution margins. The latter might be facilitated by liberalizing the distribution sector.
OBJECTIVES: To compare prices of in-patent active ingredients (AIs) in Europe at three levels (ex-factory prices, net distribution margins and third party payers' prices). METHODS: We compared the prices in seven EU countries (Belgium, France, Germany, Italy, the Netherlands, Spain and the UK) of the 20 in-patent AIs most sold on the Italian retail market in 2004, based on "sell in" sales data. We calculated the average ex-factory price per unit of each compound in each of the seven countries, weighted by the volumes of all reimbursable package sizes and strengths. We estimated net distribution margins according to the 2004 domestic regulations by deducting any type of mandatory discount. Finally, we added VAT to calculate "third party payer's prices". All prices were expressed in index numbers (Italy=100). RESULTS: Italy had the lowest average ex-factory prices, the Netherlands and particularly the UK had by far the lowest distribution margins, while Germany had by far the highest third party payers' prices. The Netherlands and particularly UK showed a steep decrease from ex-factory to third party payers' prices, while Belgium, Italy and Spain gave the opposite pattern. CONCLUSIONS: Our study suggests that public authorities can deal with drug prices both by strictly controlling ex-factory prices and by establishing appropriate distribution margins. The latter might be facilitated by liberalizing the distribution sector.
Authors: Silvio Garattini; Vittorio Bertele'; Brian Godman; Alan Haycox; Björn Wettermark; Lars L Gustafsson Journal: Eur J Clin Pharmacol Date: 2008-12 Impact factor: 2.953
Authors: Björn Wettermark; Marie E Persson; Nils Wilking; Mats Kalin; Seher Korkmaz; Paul Hjemdahl; Brian Godman; Max Petzold; Lars L Gustafsson Journal: BMC Health Serv Res Date: 2010-05-17 Impact factor: 2.655
Authors: Jakub Adamski; Brian Godman; Gabriella Ofierska-Sujkowska; Bogusława Osińska; Harald Herholz; Kamila Wendykowska; Ott Laius; Saira Jan; Catherine Sermet; Corrine Zara; Marija Kalaba; Roland Gustafsson; Kristina Garuolienè; Alan Haycox; Silvio Garattini; Lars L Gustafsson Journal: BMC Health Serv Res Date: 2010-06-07 Impact factor: 2.655
Authors: Brian Godman; William Shrank; Bjorn Wettermark; Morten Andersen; Iain Bishop; Thomas Burkhardt; Kristina Garuolienè; Marija Kalaba; Ott Laius; Roberta Joppi; Catherine Sermet; Ulrich Schwabe; Inês Teixeira; F Cankat Tulunay; Kamila Wendykowska; Corinne Zara; Lars L Gustafsson Journal: Pharmaceuticals (Basel) Date: 2010-08-05