IHS Global Insight Perspective | |
Significance | The update to Slovakia's drug reimbursement list introduced in October contains 15 new proprietary medicines. |
Implications | Variable co-payments for cheaper more genericised medicines have been increased, with savings being used to increase the reimbursement of more expensive and innovative drugs. |
Outlook | Slovakia's current drug reimbursement policy is beneficial for producers of innovative, proprietary medicines, and less favourable for generics producers; this is set to continue as the country's economy is expected to recover from 2009's slump in 2010. |
The update to the drug reimbursement list introduced in Slovakia at the beginning of October contains 15 new proprietary drugs, reports Slovak newspaper Cas. Among the new proprietary treatments are U.S. firm Elli Lilly's major depressive disorder drug Cymbalta (duloxetine HCI), French company Servier's depression treatment Valdoxan (agomelatine), Swiss pharma Novartis' hypertension drug Rasilez (aliskiren), and Swiss company Roche's rheumatoid arthritis drug RoActemra (tocilizumab), the first interleukin-6 receptor inhibiting monoclonal antibody developed for the treatment of the disease.
Proprietary Drugs Included in October Reimbursement List Update | |||
Producer | Drug | Active Pharmaceutical Ingredient | Indication |
Merck Serono (Germany) | Kuvan | Sapropterin dihydrochloride | Hyperphenylalaninaemia due to phenylketonuria or tetrahydrobiopterin deficiency |
GlaxoSmithKline (U.K.) | Arixtra | Fondaparinux | Prevention of vascular obstruction |
Vifor Pharma (Switzerland) | Ferinject | Ferric carboxymaltose injection | Iron replacement |
Novartis | Rasilez | Aliskiren | Hypertension |
Janssen-Cilag (U.S.) | Stelara | Ustekinumab | Psoriasis |
Bayer Schering Pharma (Germany) | Finacea | Azelaic acid | Rosacea |
Eli Lilly | Cymbalta | Duloxetine HCl | Major depressive disorder |
Servier | Valdoxan | Agomelatine | Major depressive episodes in adults |
AstraZeneca (U.K.) | Zomig | Zolmitriptan | Migraine |
Roche | RoActemra | Tocilizumab | Rheumatoid arthritis |
Schering-Plough (U.S.) | Aerius | Desloratadine | Allergic rhinitis and chronic idiopathic urticaria |
Merck & Co. (U.S.) | Singular | Montelukast | Asthma |
Fresenius (Germany) | OsvaRen | Calcium acetate and magnesium carbonate | Hyperphosphataemia in dialysis patients |
Axcan Pharma (Canada) | Ursofalk | Ursodeoxycholic acid | Gallstone dissolution |
Pfizer (U.S.) | Zithromax/Zmax | Azithromycin extended release | Antibiotic |
Source: Cas | |||
Elsewhere on the list, the general trend is for patient contribution to cheaper, more genericised treatments such as antibiotics to be increased (see Slovakia: 14 September 2009: Slovakian Drug Reimbursement Growth Curtailed in October Reimbursement List). In the case of 1,121 products, the variable patient co-payment has increased; out of these, in the case of 330 products, the co-payment has risen by more than 1 euro (US$1.5). The patient co-payment has declined in the case of only 565 medicines.
Money Saved on Cheaper Medicines to Be Spent on More Expensive Ones
The savings made by increasing patient co-payments on less expensive medicines is being spent on increasing the reimbursement of more expensive, innovative medicines, Slovakian Ministry of Health spokesperson Zuzana Cizmarikova told the source. However, this will not mean a proliferation of very expensive medicines, Cizmarikova told Cas; every other medicine on the reimbursement list is either available without any co-payment, or with a co-payment of no more than 1 euro, she emphasised.
Outlook and Implications
Slovakia scored the second-highest total in the category of Pharmaceuticals in the Healthcare Consumer Powerhouse 2009 report on the state of healthcare systems in Europe (see Europe: 1 October 2009: Netherlands Tops European Health Consumer Poll for Second Successive Year). Although the scores in the report were weighted, the result reflects the fact that in Slovakia there is a high level of accessibility to innovative and expensive pharmaceuticals relative to other countries in the Central and Eastern Europe region. This is reflected in the inclusion of so many new proprietary drugs in the recent reimbursement list update in Slovakia, compared with just two in the recent update in Poland.
As Slovakia's current cost-containment policy is focusing on pushing down the prices of cheaper drugs and reducing their reimbursement, and then spending the savings on innovative and more expensive drugs, it benefits producers of the latter type of drugs, rather than generics producers. With the Slovakian economy set to recover quite substantially from its slump in 2010, it is likely that this reimbursement trend will continue.