Are forced drug discounts needed? No, "they are useless and do not achieve the goal of rationalizing consumption" answer the researchers of CERM, an independent research center engaged in the issues of competitiveness, regulation and markets. According to the centre, directed by the economist of the University of Florence Fabio Pammolli, the only effective tool is the percentage co-payment, ie a co-payment proportional to the price of each class A drug.
A partnership required of the citizen and, obviously, coordinated between the State and the Regions. An editorial signed by Pammolli and Nicola Salerno, published on the centre's website, is dedicated to the theme of pharmaceutical market regulation. The thesis is based on the trend of consumption and expenditure in the last period. Between 2000 and 2005 the daily doses of reimbursed drugs (daily ddd per 1000 population) increased by approximately 39% and an increase of the same order (36%) had prescriptions. The Osmed data for the first nine months of 2006, which record +7.2% compared to the same period in 2005, “demonstrate that the trend is persistent. "At these rates - comments Salerno - the consumption of reimbursed drugs will double in fifteen years and will increase more than six times by 2050, according to Ecofin projections".
The price cut, the analysis continues, is useless in itself also for an accounting reason. In fact, if there is an overconsumption of drugs in a given year, we are dealing with a historical fact which cannot be erased tout court, and which is not actually eliminated but financed with greater resources taken in the following year through the price cut. “Consequently, in the following year, the expenditure relating to that year is accounted for as if the prices had not been cut, because it finances the expenditure of the previous year. So – argues Salerno – it's a dog chasing its tail, because you don't act, as you should, on consumption, but only find more resources to make up for the previous year”.
A partnership required of the citizen and, obviously, coordinated between the State and the Regions. An editorial signed by Pammolli and Nicola Salerno, published on the centre's website, is dedicated to the theme of pharmaceutical market regulation. The thesis is based on the trend of consumption and expenditure in the last period. Between 2000 and 2005 the daily doses of reimbursed drugs (daily ddd per 1000 population) increased by approximately 39% and an increase of the same order (36%) had prescriptions. The Osmed data for the first nine months of 2006, which record +7.2% compared to the same period in 2005, “demonstrate that the trend is persistent. "At these rates - comments Salerno - the consumption of reimbursed drugs will double in fifteen years and will increase more than six times by 2050, according to Ecofin projections".
The price cut, the analysis continues, is useless in itself also for an accounting reason. In fact, if there is an overconsumption of drugs in a given year, we are dealing with a historical fact which cannot be erased tout court, and which is not actually eliminated but financed with greater resources taken in the following year through the price cut. “Consequently, in the following year, the expenditure relating to that year is accounted for as if the prices had not been cut, because it finances the expenditure of the previous year. So – argues Salerno – it's a dog chasing its tail, because you don't act, as you should, on consumption, but only find more resources to make up for the previous year”.
The economic variable to correct is instead that of consumption, a difficult correction that was never achieved in the decade. For this reason, the pharmaceutical sector continues to suffer from public finance sustainability problems. However, cutting prices not only does not solve the problem but has the consequence - according to Salerno - of "putting the market to sleep". In Italy, this is the explanation, unlike other countries, there is an undifferentiated market of products subjected to a generalized downward compression of prices, without distinction between patent-protected and truly innovative medicines, medicines no longer under patent protection and generic". On the contrary, in other countries, there is a clear division between unpatented products subjected to very strong competition, sold at minimum prices and margins throughout the supply chain, and patented products that can afford fairly high prices, thanks to the savings made over the others, which reward innovation and research”.
The same does not happen in Italy, according to the researcher. In his opinion, Italy's pricing policy “slows down research and development and delays the launch of truly innovative products compared to other countries, with the repercussions of lower growth at an industrial level. Not only. Cutting the price lists greatly reduces the difference between the price of 'branded' drugs and that of the generic, which is the element that attracts any genericist. In other words, it puts the market to sleep”. Hence the 'recipe' of Cerm: a ticket for products in range A proportional to the price, obviously in compliance with the exemptions for the weaker groups. And not a recipe ticket
