by Little L
Sun Feb 12th, 2006 at 05:50:04 AM EST
Ever since its creation the European Union is trying to enforce to its current or aspiring member states regulations and uniform standards for everything. When it comes to determining the prices of medicines for the state health systems, the "ever-closer" Union follows another scheme- every country by itself.This presents a challenge to the prosperity of the health sector and an obstacle for the successful integration of the ten new member states and the other two, Bulgaria and Romania, which are awaiting a carte-blanche from the European Commission later this year.
The obvious explanation is the significant wealth gap among the countries in United Europe. Overall, the healthcare budget of the EU countries is between eight and nine per cent of the country's national GDP. In Bulgaria, the percentage is twice as small. The widest discrepancies can be found in the percentage of the healthcare budget devoted to purchase of medicines- in Western Europe it is about 15 per cent, whereas in a poorer country like Slovakia it can go up to 50 per cent.
Then follows the explanation- big pharmaceutical companies are far more reluctant to negotiate discounts for purchase of expensive drugs with a medium-income country like for instance Bulgaria, which has a small market volume. Its low healthcare state budget does not offer space for high patient reimbursement for the purchase of expensive and often life-saving prescription drugs. For a certain drug, a country like Norway would reimburse the patient fully, while in Bulgaria a patient would have to pay up to 70 per cent of the price for the same medicine. This results in inequality of the European citizens to the access of new medicines and therapies and therefore, considerable discrepancy in the health standards of the different countries.
The governments of the European countries are reluctant to collaborate when working with pharmaceutical firms, which are trying to impose maximum prices for their newest products. The whole negotiation process is often kept a secret, because rich countries are afraid that they can miss the good deal with the pharmaceutical company as they are the only ones that have the capacity to work out a discount. In poorer countries, such negotiations take much longer time and by the end of the day, governments may find themselves forced to wait for years until a prescription medicine becomes old and therefore cheaper. Sometimes, this presents a life-threatening situation to the patients.This way innovative medicines are often left out of the market of a poorer country. Neither can one take a drug across the border because prescriptions apply only in the country if origin. An avian flu pandemic is threatening Europe and now every country negotiates the price of the vaccine Tamiflu separately, without presenting any information about the deal or the negotiated price to the public.
For now, the Baltic countries are the only ones who are experimenting with a joint purchase of pharmaceutical products. This would also be a good idea in other regions of Europe- for example the Czech Republic, Slovenia and Slovakia could also unite their efforts to get better prices and offer better health services to their citizens. Of course, Western countries would rather opt for differential pricing of drugs instead of having the market adjust them, because they would have to pay more than they do now. But a joint action is always a better example to follow and will hopefully prove economically feasible to the Union, especially having in mind that the European healthcare market is still falling behind its main competitor- the US.
