Sweden’s financing, pricing, and organisation of the introduction of new drugs and vaccines is not meeting the country’s needs, according to the Minister for Social Affairs, Jakob Forssmed (EPP). Forssmed has announced a comprehensive overhaul just six months before the Swedish general election.
“The state should take greater responsibility for the introduction of medicines and vaccines, and how they are to be subsidised. We should not have the parallel systems for decisions on medicines that we have today,” he told Euractiv.
The new governmental inquiry will look into how to establish a single, coherent organisation that could address future healthcare needs and the introduction of new medicines and vaccines, largely financed and governed by the state, he said.
The investigation will also look into risk and cost-sharing models between the state and the regions.
Complicated pharma system
The processes for funding and introducing new medicines and vaccines are currently divided and complex, depending on whether the medicine is dispensed by an outpatient pharmacy or a hospital.
The Dental and Pharmaceutical Benefits Agency (TLV) decides whether prescription medicines are included in the benefits scheme and sets the pharmacy purchase price. The regions cover the cost with state grants.
For hospital medicines, the New Therapy Council (NT-Council), established by the 21 Swedish regions, gives recommendations on which drugs are cost-effective and should be purchased. These prices are negotiated behind closed doors by the regions, with financing coming from regional taxes.
Moreover, several processes are also involved in the decision-making and roll-out of vaccines.
“Today’s system is not transparent enough. It’s difficult for those wishing to introduce new treatments to understand. These processes can sometimes feel a bit like a black box. That sort of uncertainty isn’t helpful in this context,” he said, adding, “What’s more, there’s also a competitive element. Where do [drug makers] choose to introduce new treatments, and where not to?”
The MFN factor
The inquiry shall also suggest a state-governed organisation that will handle negotiations with drug producers regarding confidential prices for drugs.
This is at a time when the US is seeking access to confidential prices under the US “most-favoured-nation” reference pricing model.
In the inquiry’s mandate, the Swedish government highlights the international context, noting that as many countries benchmark public medicine prices against others abroad, the use of confidential pricing becomes more significant.
Positive reception
Stakeholders, in general, seem content with the new investigation. “It points to the current problem with patients who have to wait too long to have access to new drugs. We now hope that more will have the chance,” Anders Åkesson, the Chair of the Swedish Heart and Lung Association, told Euractiv.
However, as the inquiry is expected to conclude at the end of 2027, any reform will probably be implemented after 2028.
“Until then, more must be done to promptly help risk groups, such as the elderly and patients with rare diseases, get rapid access to the drugs or vaccines they need,” he added.
LIF (the Swedish Association of Research-Based Pharmaceutical Companies) said it is pleased by the move.
“This is an important and long-awaited step. The government has identified a fundamental problem in the current system – that responsibility is divided between the state and the regions, which leads to unequal access and a lack of predictability,” Sofia Wallström, CEO of LIF, told Euractiv.
She also noted that the global competition for investment, research, and early access to new medicines is intensifying. “This means that the question of how we organise and finance medicines is not just a welfare issue, but also a strategic issue for Sweden’s competitiveness and resilience.”
A one-way in and negotiating prices with a single central part would, she said, “result in shorter processing times and allow for the use of payment models where necessary.”
TLV Director General Magnus Thyberg said it is “crucial to ensuring both cost control and good access to medicines for patients.” He told Euractiv that the financier needs more control over how drugs are prescribed and called for the state to increase its governance. However, this will be investigated in accordance with the directives to the investigator, without limiting doctors’ right to prescribe medicines.
Election year
The launch of the inquiry comes six months ahead of the Swedish general election in September, and nine months after a parliamentary committee, which was looking into a nationalisation of the Swedish healthcare, recommended greater state responsibility.
“It’s good that something is happening. We have been calling for the state to take control of medicines. But it’s definitely something to bear in mind in the run-up to the election,” said Karin Rågsjö, health spokesperson for the Left party, a MEP and ex-member of the committee.
The government has chosen Karin Johansson, the vice CEO of the Confederation of Swedish Enterprise, the country’s largest employers’ organisation, to lead the inquiry, which has surprised Rågsjö.
“I would have liked to see someone with a different background from Johansson. Someone with a background in the welfare sector. The current choice could be interpreted as the government bringing in someone with a strong commercial drive,” she said.
[VA, BM]
Source:
www.euractiv.com