Is Europe still heading to a common price level for on-patent medicines? An exploratory study among 15 Western European countries.
BACKGROUND
Previous studies have suggested that medicines prices in Europe converge over time as a result of policy measures such as external price referencing.


OBJECTIVE
To explore whether ex-factory prices of on-patented medicines in Western European countries have converged over a recent period of time.


METHODS
Prices of ten on-patent medicines in five years (2007, 2008, 2010, 2011, 2012) of 15 European countries were analyzed. The unit of analysis was the ex-factory price in Euro per defined daily dose (exchange rate indexed to 2007). A score (deviation from the average price) per country as well as the ranges were calculated for all medicines.


RESULTS
The prices between countries and selected products varied to a great extent from as low as an average price of € 1.3/DDD for sitagliptin in 2010-2012 to an average of € 221.5/DDD for alemtuzumab in 2011. Between 2008 and 2012, a price divergence was seen which was fully driven by two countries, Germany (up to 27% more expensive than the average) and Greece (up to 32% cheaper than the average). All other countries had stable prices and centered around the country average. Prices of less expensive as well as expensive medicines remained relatively stable or decreased over time, while only the price of sirolimus relatively increased.


CONCLUSIONS
Our study period included the time of the recession and several pricing policy measures may have affected the prices of medicines. Instead of the expected price convergence we observed a price divergence driven by price changes in only two of the 15 countries. All other European countries remained stable around the country average. Further research is needed to expand the study to a bigger sample size, and include prescribing data and Eastern European countries.
Department of Health Economics, Gesundheit Österreich GmbH/Austrian Health Institute/WHO Collaborating Centre for Pricing and Reimbursement Policies, Vienna, Austria; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences/WHO Collaborating Centre for Pharmaceutical Policy and Regulation, Utrecht, The Netherlands. Electronic address: Christine.leopold@goeg.at.
Christine
C
Leopold
Aukje Katja
AK
Mantel-Teeuwisse
Sabine
S
Vogler
Kees
K
de Joncheere
Richard Ogilvie
RO
Laing
Hubert G M
HG
Leufkens
D016527:Drug Costs / Q000706:statistics & numerical data*; D004465:Economic Competition; D057172:Economic Recession; D005060:Europe; D006801:Humans; D008137:Longitudinal Studies; D010330:Patents as Topic
Europe; Financial recession; Medicines price comparison; On-patent medicines