European Cross-Country Pricing Collaborations Gather More Steam
Executive Summary
Iceland has joined the Denmark-Norway pricing alliance while Denmark could soon join the BeNeLuxAI collaboration.
Cross-country collaboration on pharmaceutical pricing is gaining further traction among Nordic countries with Iceland joining an alliance between Norway and Denmark to secure more sustainable access to medicines. Meanwhile, Denmark may soon be joining Europe’s most advanced pricing collaboration to date, the BeNeLuxAI initiative.
Norway and Denmark signed a joint procurement deal in September 2018 in a bid to secure lower prices for high cost medicines and a more secure supply of low cost, off-patent products. At the time, the head of the Danish medicines procurement agency Amgros told the Pink Sheet that the agreement was a signal that payers “will fight [industry] with every weapon that we have” to achieve lower prices.” (Also see "Nordic Procurement Deal Signals New Weapons In Fight For Lower Prices " - Pink Sheet, 11 Oct, 2018.)
Iceland signed up to the agreement on April 23 in Reykjavik. It said co-operation among the parties could lead to more efficiency and lower drug prices. “There is concern all over the world that some new drugs are so expensive that their cost is delaying access. This is a problem in Iceland, as in the partner countries,” health minister Svandís Svavarsdóttir said in a statement.
Where innovative medicines are concerned, joint negotiations will focus on medicines for small patient groups which are expected to have very high prices. However, the Icelandic health ministry’s statement says the agreement places emphasis on improving the supply of essential medicines that have been available for some years.
Tackling shortages
Shortages of certain medicines - largely, older, off patent medicines - is a growing problem in Iceland and neighboring countries, said the Icelandic health ministry. It pointed to the memorandum signed by Denmark and Norway last September, which states that pharmaceutical companies have “tightened up” their business practices, for example by decreasing stock supplies. Meanwhile, the supply chain has become more vulnerable, for example because there are fewer suppliers and production sites. Prices of generic medicines “are so low that some suppliers are starting to withdraw from the market,” it said.
The group has already published its first joint procurement exercise and is seeking bid from companies to supply: methotrexate, anagrelide, meropenem, ondansetron, gentamycin, and paracetamol.
“Prices of generic medicines are so low that some suppliers are starting to withdraw from the market” – Icelandic health ministry
“We believe such collaboration can be the way to go to achieve better consistency in supply. This is the first procurement we make with our neighbours. And if it is successful, we look forward to collaborating on several drug procurements,” said Lise Grove, purchasing director at Amgros.
The collaboration is open to other countries too, but Amgros told the Pink Sheet it was unaware of any additional countries that were considering joining up.
BeNeLuxAI?
Separately, the Pink Sheet understands that Denmark wants to join BeNeLuxAI, a cross-country collaboration made up of Belgium, the Netherlands, Luxembourg, Austria and, most recently, Ireland. This is the most advanced of Europe’s joint pricing initiatives and has already secured access in Belgium and the Netherlands to Biogen’s spinal muscular atrophy treatment Spinraza (nusinersen) following a joint health technology assessment and pricing talks. More products have been targeted for pilots. (Also see "EU Cross-Country Coalition Targets New Products For Joint Pricing Talks " - Pink Sheet, 15 Feb, 2019.)
Asked to comment on the matter, Amgros declined to comment on Denmark’s joining intentions. However, it told the Pink Sheet: “As Amgros wants to be internationally recognized as a role model in translating healthcare needs into action, we are constantly looking for inspiration and experiences from other countries.”
Other pricing initiatives include the Valletta group, which includes Spain, Italy, Portugal, Greece, Malta, Cyprus, Ireland, Romania and Slovenia, and Croatia and the FINOSE Project, made up of Norway, Sweden and Finalnd. (Also see "Sweden, Finland & Norway Gear Up For First Joint HTA Under FINOSE Project" - Pink Sheet, 4 Oct, 2018.)
From the editors of Scrip Regulatory Affairs