Objectives: To assess the impact of an International Reference Pricing (IRP) on Access to Standard Therapy of Asthma and/or COPD in Slovakia. Methods: Analyzing 2012-2015 data on utilization of selected asthma and COPD standard therapy drugs (ATC R03AK, DDDs, quarterly) from three official and independent sources (IMS Sell-In, National Centre for Health Informatics and State Institute for Drug Control) in order to assess the impact of IRP and calculate the possible bias of parallel trade on access to therapy in Slovakia Results: The more strict fine-tunnning of the Drug Policies in 2011 has created the opportunity for significant cost-reduction in public resources for pharmaceuticals in Slovakia. However, our analysis of data has shown, that the more strict the policy, in terms of International Reference Pricing, the higher is the “temptantion” for “channel management” / parallel trade from low-price to high-price countries, both on the level of the wholesalers as well as the Public Pharmacies. Our finding on ATC R03AK has shown significant differences (DDDs recorded) in originally independent sources of drug utilization. Moreover, we have identified even suspected malpractice in prescribing and reimbursing selected drugs to Slovak patients, due to parallel trade business-driven demand. The findings has confirmed our original hypothesis, that an aggressive IRP Drug Policy leads in mid-term towards decrease in access for national population. Conclusions: International Reference Pricing, originally perceived as an effective and efficient tool for cost-containment strategies across EU, has reached its optimal potential. Further pressure on ex-facotry prices in low and middle-income European countries (e.g. Slovakia) generates the possible source of drugs shortage on national level in mid-term, and thus represents the high long-term risk for the healthcare outcomes, in terms of chronically treated patient compliance and adherence to therapy, due to the lack of physical availability of standard therapy drugs on the Slovak market.
Visnansky, M., & Kababikova, D. (2016). Impact of The International Reference Pricing on Access To Standard Therapy Drugs for Asthma and Copd. Value in Health, 19(7), A560. https://doi.org/10.1016/j.jval.2016.09.1234