Pharmaceutical prices in India

Abstract

In Finland, primary and secondary healthcare services are provided to all residents by municipalities, small local governing areas. The municipal health services cover drug treatments administered during primary and secondary healthcare visits. As healthcare units procure such drugs directly from pharmaceutical companies through competitive bidding, purchase prices vary. In 2013, drugs procured by healthcare units represented 18% of the total pharmaceutical expenditure in Finland. The municipal health services are complemented with National Health Insurance, a universal public insurance for all residents. National Health Insurance reimburses curative drugs dispensed at community pharmacies, at basic (35%) or special (65 or 100%) levels depending on the illness and drug necessity. Drugs are included in the insurance based on manufacturers' applications for reimbursement status and a reasonable wholesale price, from the Pharmaceuticals Pricing Board under the Ministry of Social Affairs and Health. Products with new active ingredients require a health economic evaluation as part of the application. With or without reimbursements, drug prices are the same in all community pharmacies, consisting of a wholesale price, standardised pharmacy-margins, a value added tax, and a fixed dispensing fee. In 2013, prescription-only drugs purchased from community pharmacies represented 71% and non-prescription drugs 12% of the total pharmaceutical expenditure in Finland. In 2013, 63% of the total costs of drugs dispensed at community pharmacies were reimbursed to patients. Under generic substitution, pharmacies substitute prescribed drugs with cheaper substitutable drugs. In the reference price system, the cheapest substitutable drug also determines the maximum reimbursement for patients. © Springer International Publishing Switzerland 2015.