Drug reimbursement expenditure in Lithuania increased by 6.2% year-on-year in 2012, reversing the downward trend of the previous two years. Meanwhile, following meetings between groups representing the pharmaceutical industry and the Lithuanian authorities, it appears likely that some changes will be made in the coming months to drug and reimbursement policy in the country
IHS Global Insight perspective | |
Significance | Figures from 2012 show that the downward trend for drug reimbursement spending in the country has reversed, with spending up 6.2% year-on-year in 2012. Meanwhile, following meetings between the Lithuanian authorities and groups representing the pharmaceutical industry, important changes and new developments in the country's drug and reimbursement policy have been called for. |
Implications | Following the years in which the global economic crisis had an impact on Lithuania, the country is now in better shape, which is reflected by 2012's more generous public pharmaceutical reimbursement spending. |
Outlook | With only a small increase planned in reimbursement spending during 2013, the Lithuanian authorities are continuing to adopt a cautious position, although it remains the case that there is considerable room for increasing public spending on drug reimbursement in the country, and with this in mind, the calls for changes to drug and reimbursement policy and the development of a new set of policies are all the more important. |
Pharmaceutical reimbursement up 6.2% y/y
Spending on outpatient pharmaceutical reimbursement by Lithuania's Mandatory Health Insurance Fund (PSDF) in 2012 reached LTL608.1 million (USD226.128 million), which represented an increase of 6.2% year-on-year (y/y), according to data revealed recently by the Lithuanian National Health Insurance Fund (VLK). The data can be viewed in full, in Lithuanian, here. Spending on medical devices increased by 8.3% y/y to LTL52.5 million, making the combined value of reimbursement expenditure on both drugs and medical devices LTL661 million. This compares with LTL621 million in 2011, which was the second year in succession in which this value fell, from a high of LTL696 million in 2009.
Co-payments up
The total paid out by patients in the form of co-payments for reimbursed drugs in 2012 increased by 4.9% y/y to LTL155.9 million. Taken together with co-payments for medical devices (which remain quite small, reaching a combined total of LTL3.0 million in 2012), co-payments in 2012 were up 4.7% y/y, compared with two years of reductions – by 8.3% y/y in 2011 and 22.6% y/y in 2010. In previous years, co-payments had grown consistently, even at double-digit rates from 2005 to 2008.
Prescription numbers and average cost up
The number of prescriptions written out to patients in Lithuania reached 12.0 million in 2012, following a consistent upward trend from 11.7 million in 2011 and 11.6 million in 2010. Meanwhile, the average cost of one prescription to the PSDF in 2012 was LTL55.2, up from LTL53.3 in 2011, which in itself was a drop from LTL56.1 in 2010 and LTL61.2 in 2009.
As stated by the VLK in a press release, in order to regulate the expense of drug reimbursement to the PSDF in 2012, the VLK was engaged in 53 contracts with 24 drug producers for 47 drugs, as a result of which the producers returned a reported LTL21 million back to the PSDF budget. In the press release, it is also stated that drug and medical device reimbursement is planned to increase to LTL670 million, a small increase on the 2012 figure of LTL661 million.
Development of new drug policy urged by industry groups
Meanwhile, following a meeting involving organisations representing different groups involved with the pharmaceutical industry, It was proposed that a new long-term drug policy be developed in the country. Vytenis Povilas Andriukaitis, Lithuania's health minister, is reported as saying in a press release published by the Lithuanian Ministry of Health (MoH) that the issues discussed at the recent meeting included the "aggressive" marketing and advertising of some pharmaceutical companies, doubts over the introduction of centralised procurement, and the scaring of the public regarding generics. The head of Lithuania's Innovative Pharmaceutical Industry Association, Leonas Kaletinas, is reported as saying that even though pharmaceutical companies have their own code of ethics, they often do not stick to it, adding that there should be severe penalties for violations, including delisting from the reimbursement list. Eduardas Tarasevicius, the president of the Lithuanian Pharmaceutical Association, is quoted as saying that the MoH must develop a long-term programme for the country's drug policy.
Additionally, Algis Sasnauskas, the president of the VLK, is reported to have met with representatives of the pharmaceutical industry in Lithuania, with an outline of this meeting being given in a VLK press release. Sasnauskas reportedly said that changes in the drug reimbursement system are needed. He also emphasises the need to improve purchasing so that drugs can be bought at lower prices, while also stating that he wants to focus on ensuring equal competition for pharma companies, also to enable them to provide their products at "optimal" prices.
Outlook and implications
Lithuania, like its Baltic neighbours, is emerging from a fairly deep crisis that hit the country in 2009–10, related to the wider economic problems being experienced globally at that time. It can be seen that in 2010 and 2011, this resulted in significant reductions in reimbursement spending, which can also be traced back to the implementation of prescription by international non-proprietary name in the first quarter of 2010, and also the implementation of stronger controls of the prescribing habits of doctors. Considering the very low level of reimbursement expenditure in the country – which has a population of around 3 million people – there is certainly continued scope for increased expenditure as the economic situation improves. However, the tone adopted by the MoH and VLK remains quite combative towards the pharmaceutical industry, so it is to be hoped that whatever path the mooted changes to the country's drug reimbursement policy follow, there will be sufficient consultation with all players in the pharmaceutical industry, and also that there can be a workable consensus.