Filenews 16 October 2024 - by Marilena Panayi
Spending on securing medicines, mainly specialised and innovative treatments, is soaring across Europe.
Medicines for cancer, rare diseases, metabolic diseases and diabetes already pose a huge risk to the sustainability of national health systems across Europe and raise before the competent health/insurance authorities the huge dilemma of saving over specialization and innovation.
The increase in spending on medicines recorded between 2022-2023 ranged at European level from 3.6% to 13%. Cyprus is at the highest point of increases for this year, while countries such as Germany, Spain, Belgium and Latvia have recorded a significant annual increase in spending over the last three years, but have not increased the quantities of medicines supplied for the needs of their patients.
Sweden, according to a relevant report, between 2022 and 2023 recorded an increase of 11% with the rate of increase for securing specialized medicines (mainly "orphan" ones listed for rare diseases) exceeding 26%.
The report prepared by the European Social Security Platform (ESIP) and the Medical Assessment Committee (MEDEV) is the subject of discussion at the third annual ESIP symposium held in Brussels and aims to develop initiatives at European level so that states can ensure the best and most effective medicines for their patients. without, however, jeopardising national or other insurance funds.
The report draws clear conclusions on why spending on medicines has skyrocketed over the past three years, and whether it lists a number of factors, such as an ageing population and increasing comorbidities.
In Cyprus, as shown in the report, the overall recording of expenditure on medicines began after 2020 and the integration of inpatient care into the General Health System. Thus, while in 2019 the expenses of the GHS for securing medicines stood at €165 million, in 2020 they rose to €273 million. continuing to record an increase (smaller than in other states) and between the years 2021-2022 at a rate of 4%.
An even greater increase was recorded between 2022-2023, reaching 13%, although, as noted in the report, this increase may be due to changes in both the country's health system and the way expenditure is calculated over the last four years. It is recalled that the HIO budget for ensuring innovative and specialized treatments is expected to be increased by approximately €70 million in 2025, as the GHS will include the treatments currently administered to patients through the procedures of the Ministry of Health with a separate budget exceeding €120 million. for 2024. For the GHS, as mentioned in the report, most of the increase in spending concerns specialized treatments for diabetes, heart failure, the immune system and cancer, which have already been integrated into the System.
As for other European countries, Portugal appears to have recorded an increase in spending in 2022 compared to 2021 and 2023 at a rate of 3.6% compared to 2022. Norway, in the year under review, 2022-2023 shows an increase in expenditure of 6%, Austria 7.1%, Belgium and Finland 9%, Latvia 14.3%. The Netherlands in the three-year period 2021-2024 recorded an average annual increase of 3.5%, with the year 2022-2023 showing an increase of 4.8%.
The report comes just a month after pharmaceutical companies expressed concern that the amount spent by states on medicines was declining.
The two bodies that prepared the report recommend centrally that the EU and the Member States take measures to ensure that all necessary treatments are provided to patients who need them, but without allowing health systems to be eroded.
At this stage and at EU level, an effort is being made to stem the rise in prices of specialised medicines, in particular oncology and rare disease medicines. In the case of rare diseases, for which so-called orphan drugs are administered, prices seem to have skyrocketed. Orphan drugs are medicines intended for a very small number of patients internationally and mainly concern very rare diseases.
It is reported that in Cyprus, these medicines are administered through the procedures of the Nominal Requests Committee of the Ministry of Health, whose budget jumped from €3 million in 2015 to €120 million in 2024.
Recommendations to EU members pending conclusions
Legislation is expected to be discussed among EU Member States next year and other programmes will strengthen governments' ability to monitor developments and choose the best ways to meet the real therapeutic needs of their citizens.
However, ESIP and MEDEV stress in their report that if an upward trend in drug spending continues, national healthcare systems will face serious sustainability challenges.
They recommend developing mechanisms to increase competition for rare therapies and promoting the generic and biosimilar industry so that they are ready and enter the market immediately after the patent expires of the original formulations.
The symposium is ongoing and the final results/conclusions are expected to be officially announced in the coming days. The "Health Technology Assessment" programme has been put on the table, which will start to apply from 2025 for medicines and from 2026 for medical equipment.
This program will evaluate, inter alia, the effectiveness of medicines against cost and the degree of patient satisfaction. That is why the EU has included organised patient groups in each Member State in the whole process.
