Let’s start having a serious discussion about substantive interventions in health care
- There are currently drug shortages in many other European countries. Drug shortages or shortages are a systemic problem caused by multiple external factors (war in Ukraine, shortages of raw materials, disruption of traditional trade links, logistical problems, pandemic reverberations, increased consumption, etc.).
- The introduction of a mandatory two-month supply in the Czech Republic will not solve it so easily, nor can it – the mandatory supply is to be calculated from the supply in previous months – surely this will not solve the shortage in a future epidemic, or will it?
- For 15 years, the Czech system of price and reimbursement regulation of medicines has generated prices and reimbursements derived from the lowest prices of medicines in EU countries. Thanks to this, the prices of medicines in the Czech Republic are among the lowest in Europe. But is this really an advantage? Ever lower sales revenue inevitably pushes up costs – everywhere, in production, in distribution, in pharmacy, in hospitals.
- With mandatory stocks that are not compensated, the cost of input will increase even more. Some drugs will indeed fall below break-even. They are already on the market and manufacturers, distributors and pharmacies are trading them at a loss, out of social responsibility.
- There are black sheep in every industry, but the idea that manufacturers are deliberately causing drug shortages across the board and thus abusing their position is absurd. Manufacturers want to produce and make a profit on medicines, there is nothing unfair or abnormal about that. And to do that, they need to sell. Nobody wants to drive their product off the market. And even in a shortage, they can’t raise the price – it’s regulated. So producers want to supply the market and shortages occur where for some reason they can no longer supply. Either because they really have nothing to supply at the moment, or because the market situation is so unbearable that they prefer to stop their activities there. Nobody is going to supply the market at a loss in the long term.
- The supply of medicines to the market is overregulated in the regulations, new obligations continue to restrict competition, are the conclusions of the Office of the Competition Authority, which has analysed the market of distribution of medicines in detail. The cause is therefore not abuse of position by manufacturers, which should be investigated.
- So is it right to tighten regulation further? Do we know what it will do to the market? Will it really ensure that we have enough medicines? Many experts warn that it does not. So why does the ministry want to do this?
- Is it right to discuss something so complex in the House of Commons in an abbreviated discussion and yet suggest that anyone who might think differently about the matter is bribed (!) by the pharmaceutical industry?
And how about we think about it in a broader context
- What about reducing VAT on medicines, medical devices and other similar goods paid for by insurance? We will lose some of the VAT revenue, but the same money will not have to be spent by insurance companies and will not have to be reimbursed by the state budget. So isn’t VAT on these commodities just an unnecessary redistribution?
- Isn’t health insurance supposed to be a safety net in the event of an insured event – a serious illness? Do we need it to pay for what costs less than a cappuccino a month for all insured people?
- Is it correct that the cost of distribution and, more importantly, dispensing a medicine depends on the price of the medicine? How is this related?
Patients – and let’s be personal – I, you, all of us, are hostage to the fact that we think of setting up a drug delivery system (and not just drugs) in a simple scheme. Everything as cheaply as possible so that insurance will pay for it. And that’s just not good enough, it wasn’t good enough before, and it’s not good enough now. A few more years of this and we’ll have a giant health care problem to add to the giant pension problem. So please let’s not simplify, let’s not look for politically attractive culprits and let’s start looking for possible solutions. It is high time.
Mgr. Martin Schimmer, Partner M2A Partners