Poles disappointed over pharmaceutical prices, state subsidies remain low [Advocacy Lab Content]

4 months ago 21

Eighty-five per cent of Poles believe that drug prices in the country are too high, according to a survey conducted by Ariadna, the Nationwide Research Panel for Health Market. Despite this perception, the prices of reimbursed drugs in Polish pharmacies are among the lowest in the EU.

Only two per cent of respondents stated that they are rather low or significantly low. Five per cent of those surveyed considered the prices “just right,” while eight per cent had no opinion, according to the survey reported by Rynek Zdrowia.

“On the reimbursement list, there are drugs for which a monthly supply costs less than a cup of coffee in a café,” Krzysztof Kopeć, president of the Polish Association of Pharmaceutical Industry Employers – National Drug Producers, explained to Euractiv.

Pricing of a medicine

The Reimbursement Act regulates the price of reimbursed medicines in Poland. After losing patent protection and market exclusivity, the regulations require the manufacturer of the first competing medicine to enter reimbursement to reduce the price by at least one-fourth. “Every subsequent competing drug entering the reimbursement list must be even cheaper,” Kopeć told Euractiv.

However, the amount patients pay for reimbursed medicines at the pharmacy depends not only on the price of the medicine but also on the level of subsidy provided by the Polish National Health Fund (NFZ) from health contributions.

The NFZ surcharge is calculated based on the price of the cheapest products on the reimbursement list, meaning that the more expensive the medicine, the higher the patient’s co-payment.

In Poland, the percentage level of NFZ subsidies from public funds is among the lowest in the EU. According to OECD data, it stood at 35% in 2021, compared to 81% in Germany, for example.

Kopeć points out that the situation is improving, as more and more patient groups have access to free medicines. “The recently introduced mechanism to encourage the production of medicines in Poland also reduces patients’ surcharges at pharmacies by 10% if the medicine was produced in Poland and by 15% if, in addition, its active substance was also produced in our country,” he said.

For over-the-counter and non-reimbursed medicines, the situation is different. Their prices are not regulated and are shaped by various market factors.

According to Konrad Madejczyk, Press Spokesperson and Head of the Press Office at the Supreme Chamber of Pharmacists, the escalation in over-the-counter drug prices at pharmacies is influenced by inflation, wage hikes, increased prices and margins at pharmaceutical wholesalers, and rising production costs of medicinal products.

Such costs encompass transportation expenses and the prices of active ingredients. “Furthermore, pharmacies contend with escalating operational expenses, driven by mounting interest rates on loans and increasing utility fees,” he said, adding that “Owners must also address staff expectations for wage increases.”

Complex reimbursement rules

In the survey conducted by Ariadna, Poles were also asked whether they were satisfied with the current system of payments for reimbursed medicines or if a simpler solution would be to pay a fixed fee for dispensing a package of medicine at the pharmacy.

Thirty-six per cent of respondents preferred to pay a fixed, specified amount for the medicine. For 21 per cent, the current payment rules for reimbursed medicines were deemed appropriate.

A significant percentage of respondents, 43 per cent, did not have an opinion. Such a high percentage of individuals without an opinion may indicate confusion and a lack of knowledge about the reimbursement rules in the Polish system, which is highly complex.

According to Kopeć, the solution to reduce patient expenses in pharmacies lies in increasing NFZ subsidies.

IQVIA calculated, that out of 51 reimbursed therapies that lost market exclusivity from 2015 to 2021, drugs containing the same substance were introduced in only 12 cases. “This problem is evident across the entire EU,” said Kopeć.

IQVIA therefore recommends implementing predictable pricing and regulatory mechanisms to facilitate long-term drug production and supply planning. This should include accounting for the natural level of inflation and the potential occurrence of sharp inflationary phenomena in pricing regulations for reimbursed drugs.

Additionally, Kopeć suggests the creation of a system of tangible incentives to encourage investment in the development and production of drugs and their components in Poland.

[By Paulina Mozolewska, Edited by Vasiliki Angouridi, Brian Maguire | Euractiv’s Advocacy Lab]