Reference pricing for pharmaceuticals : a policy perspective

Abstract

Objective: To analyse the introduction of reference pricing systems for pharmaceuticals in Malta, their effectiveness and adequacy to-date, and to propose possible improvements. Method: A study on 18 interviewees associated with pharmaceutical and economical pricing policies was performed. A literature review analysis of the local published media regarding the subject was also undertaken to confirm personal interpretations given and to bridge information gaps. Key Findings: There are two separate reference pricing systems in place; one for the private and another for the public health sector, operating via different economic mechanisms. Reasons for resorting to such systems centred around the lack of access and affordability of medicines. This situation had emanated from an inefficient business environment, lack of proper government regulation and management and an imbalance of power between medicines’ suppliers, consumers and patients. A total of 18 respondents participated in the study. Two out of the 18 respondents considered the system successful, 6 deemed it unsuccessful and 7 thought the system had limited success. Results show that reference pricing may be regarded as a fair and simple means of monitoring and comparing local medicine prices with those of other countries. Reference pricing systems do not cater for many of the problems associated with such pricing. Conclusions: Reference pricing cannot be taken out of context in an integrated pharmaceutical system. The situation must be tackled holistically to address the real issues hindering the establishment of fair prices of medicines for Maltese consumers. Policy systems should be constructed in accordance with Malta’s particular political, economic and cultural requirements in line with local and European Union (EU) legislation.