The plenary meeting of the «Vedomosti» Publishing House «Legal Issues of the Pharmaceutical Industry» has begun with a discussion of a pressing issue «Pricing: Features and Innovations». The topic is relevant not only for the Russian pharmaceutical market, but for the global pharmaceutical market as a whole, the moderator of the session, the General Director of the ARPM, Viktor Dmitriev, said in his opening speech.
«Recently, my colleagues and I took part in the European Healthcare forum, where the key topic was the medicines pricing. Interesting enough were the proposed practical tasks — participants had to choose a medicine for investment and determine for it an appropriate price. The conclusion, which was unanimous: investment is not humanitarian aid. When the company invests, it should clearly understand when this money will return. The return of funds depends on many components: the number of patients taking the medicine, the life expectancy of patients, the ability of the government and the insurance company to recover and etc.», — Viktor Dmitriev has noted.
In another task it was necessary to choose three nosologies for investing in medicines for their treatment. Initially, everyone had focused on the medicines for nosology, which occurs in children population, and in fact deprives them of their lives by the age of 30, but finally, when everything calculated, it turned out to be much more profitable for investors to invest in the development of medicines for people over 50 years old with oncological diseases. Both the number of patients is higher, and the probability of a refund is much higher too. The topic is absolutely ambiguous: it is not only economic, but also it is political, social and ethical one. «Naturally, all these issues are relevant for our country as well», — the speaker said.
Alexey Torgov, the Deputy General Director for work with authorities of BIOCAD, commenting the pricing methodology, has suggested using an indicative method of determining the price for all categories of medicines, as well as making changes in the list of reference countries.
«The new version of the methodology for medicines pricing excludes from the list of reference countries Ukraine and countries with the highest prices (Ireland, Italy, Denmark, Portugal), as well as the addition of a country with low prices (Serbia). Additionally, we propose to exclude from the list the Republic of Serbia and Croatia, as currently the Bank of Russia does not set an official exchange rate of the Russian ruble and the national currencies of these countries. Also, to exclude countries with a high volatility in the exchange rate of national currencies (Turkey and Romania) and countries that are the part of the EAEU», — the speaker said.
Viktor Dmitriev agreed with the speaker, adding that while talking with his colleagues from Moldova, he found out about the negative effects of the Russian list of reference countries on Moldova’s Healthcare system. Companies refuse to register their medicines in this country, because Moldova is a reference country for Russia. The population is 3 million; the market is not large, the purchasing power of the population is not high. The companies have stopped supplying their products so that their prices would not be compared with the prices at the Russian market, which is a hundred times higher along with the solvency of the population. The problem has occurred – the medicines are imported in suitcases. It turned out that the Moldovan population was placed in an uncomfortable position, and in Russia the expected effect was not obtained from the referral of prices», — the expert said.
A Deputy Head of FAS Russia, Rachik Petrosyan has noted that the definition of the substitutability and equivalence of medicines is a key importance thing for pricing in government procurement, both at the stage of formation of the initial price of the contract, and at the stage of participation in procurement. «Without solving the issue of substitutability, determining the equivalence of medicines, we will not have objective prices for medicines purchased from the budgets of all levels», — the speaker said.
From the speed of making decision by the Ministry of Healthcare of Russia to determine the substitutability of medicines, the effectiveness of spending the budget, depends the budget funds saving in particular. «Today, the information system allows to calculate the average-weighted price per unit of an active substance within one INN. Comparing these data with the costs of medicines, you can the see significant differences in prices, and very often the medicines with the highest price exist in conditions of minimal rivalry», — the Deputy Head of FAS of Russia said.
Summarizing the session, Viktor Dmitriev has noted that pricing issues are sensitive, and they need to be solved collectively. Undoubtedly, the balance of interests of business, the government and patients is extremely important. It is important to use an international experience, but it is necessary to take into account also the Russian features: the economic situation, the objectives of implementing the «PHARMA-2020» Strategy, mechanism for supporting.