The discussion with the industry about reducing drug prices is currently not taking place – BauskasDzive.lv

Representatives of the Latvian National Drug Supply Association (LNZAA), Latvian Pharmaceutical Care Association and Association of Small Pharmacies have sent a letter to the officials, expressing their concern that the discussion with the industry about lowering drug prices is not currently taking place, Jānis Lībķens, a member of the board of LNZAA, told LETA.

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The letter signed by the associations was sent to Prime Minister Evikas Siliņi (JV), as well as to the Ministry of Health (MoH), the Ministry of Finance, the Ministry of Economy and the Ministry of Justice.

As Lībķens explains, the associations want to receive information and calculations about the expected changes in medicine price calculations and methodology, because the industry has not received such information from the Ministry of Health, despite the fact that the Minister of Health Hosams Abu Meri (JV) has been promising a reduction in medicine prices for a long time in the public space and generally talks about plans for drug price policy reform.

The letter, signed by industry organizations, states that there is no official, publicly negotiable document available to market participants, which includes the planned drug price calculations or their methodologies. Also, no calculation of the administrative burden or evaluation of the impact of the price change offer on the population and the industry has been received, just as there have been no meetings during which a constructive discussion on specific reform offers would have started.

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As stated in the letter, so far, in order to present the possible reform of medicine prices, the ministry has created two two-slide presentations with the indication “confidential”, but the answers to the questions that have arisen for the industry have not been provided in writing, nor at the meeting of the Consultative Council of the Pharmaceutical Sector in April the end.

The associations state that for now it is not possible for the industry to start any evaluations and calculations, because the ministry has not made its data publicly available. The industry is concerned that a real discussion on drug price reform is not planned at all, or that it will be deliberately started late.

The signatories of the letter also emphasize that they support the reduction of value-added tax (VAT) for medicines and the recently started expansion of the range of compensable medicines and diagnoses, but in addition, initiatives would be needed to unify the list of compensable medicines and make the possibilities for reimbursement of medicines for the citizens of Latvia equal to the citizens of Estonia and Lithuania.

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In addition, the organizations also call for an in-depth evaluation of whether joint purchases of critical and other important medicines can be organized in the Baltic States, which was discussed by health ministers at an informal meeting in Brussels in April this year.

The Latvian National Pharmaceutical Supply Association is a non-governmental organization founded in 2005 as the Latvian Pharmaceutical Wholesalers Association. Association members are “Recipe Plus”, “Tamro” and “Magnum Medical”.

Latvian Pharmaceutical Care Association is a non-governmental organization founded in 2008 as the Association of Pharmacy Owners. Since May 2021, it has been operating as the Pharmaceutical Care Association of Latvia. SIA “Benu aptieka Latvija”, SIA “Apotheka”, AS “Sentor Farm Aptiekas” and SIA “Latvijas aptieka” operate in the association.

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The association of small pharmacies was registered in January of this year. One of its goals is to ensure that health care policy is focused on preserving the operation of small and independent county pharmacies and ensuring the continued availability of pharmaceutical care to patients in remote and sparsely populated areas.

As Abu Meri previously told LETA agency, while continuing the work started on promoting the availability of medicines to Latvian citizens, the ministry is currently conducting negotiations with the pharmaceutical industry, which is not going easily due to different opinions. The Minister stated that the Ministry of Interior is trying to be objective, trying to find a compromise so that the planned changes do not affect the availability of pharmacies.

Abu Meri hopes that the new pricing models will be adopted by the Cabinet of Ministers by July 1, so that the personal expenses of the population for prescription drugs will decrease by about 15-20% already in the fall.

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LETA already wrote that the Ministry of Health’s new drug price reduction model was prepared by analyzing the pharmaceutical regulation of Lithuania, Estonia and Finland. It envisages abandoning the existing system, in which the permissible percentage mark-up for wholesalers and pharmacies depends on the price set by the drug manufacturer, instead introducing one fixed mark-up for all reimbursable drugs and prescription drugs per package, regardless of price, as well as the fee for the pharmaceutical care service.

The Ministry of Interior explains that the proposed changes are aimed at achieving results in a short period of time and reducing personal expenses for prescription drugs for citizens by about 15-20%. This is expected to be achieved by reviewing the amount of allowable drug refills, as well as by increasing the amount of compensation determined by the state for compensable drugs. Also, work is being done on the inclusion of new medications and diagnoses in the list of compensable medications, thereby increasing the availability of medications to those residents for whom medications for effective treatment or ensuring quality of life were not previously compensated.

The proposal of the Ministry of Interior envisages setting a fixed applicable surcharge for wholesalers and pharmacies for medication packaging, as well as setting a fee for pharmacies for pharmacist consultation in the case of dispensing prescription medications, which would be partially paid for by the state. It is expected that small pharmacies would be paid more for pharmacist consultation, thus supporting their operation. In the Ministry’s view, such an arrangement will not only reduce personal expenses for medicines for citizens, but also pharmacists will be able to recommend medicines, based only on their professional knowledge, and not by issuing the most commercially advantageous medicines to the pharmacy.

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The Ministry of Health expects that as a result of such changes, patients’ compliance with the use of medication will improve, which will improve both disease control and also reduce exacerbations of chronic diseases and hospitalizations for chronic patients.

The proposals developed by the Ministry of Health envisage strengthening the role of pharmacists in health care, as pharmacies become more financially independent from wholesalers. In the Ministry’s proposal, special financial support is also provided for pharmacies in the regions, which are the only pharmacies in the neighborhood and also fulfill a social function.

From the Ministry’s point of view, the new model provides for simple and equal principles of medicine price formation and includes the joint responsibility of the state, merchants and patients in promoting the availability of medicines.