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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

A comparison of generic drug prices in seven European countries: a methodological analysis

Authors: Olivier J. Wouters, Panos G. Kanavos

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

Policymakers and researchers frequently compare the prices of medicines between countries. Such comparisons often serve as barometers of how pricing and reimbursement policies are performing. The aim of this study was to examine methodological challenges to comparing generic drug prices.

Methods

We calculated all commonly used price indices based on 2013 IMS Health data on sales of 3156 generic drugs in seven European countries.

Results

There were large differences in generic drug prices between countries. However, the results varied depending on the choice of index, base country, unit of volume, method of currency conversion, and therapeutic category. The results also differed depending on whether one looked at the prices charged by manufacturers or those charged by pharmacists.

Conclusions

Price indices are a useful statistical approach for comparing drug prices across countries, but researchers and policymakers should interpret price indices with caution given their limitations. Price-index results are highly sensitive to the choice of method and sample. More research is needed to determine the drivers of price differences between countries. The data suggest that some governments should aim to reduce distribution costs for generic drugs.
Appendix
Available only for authorised users
Footnotes
1
The dataset excluded generic drugs sold in hospital pharmacies, off-patent originator drugs, parallel-traded products, and off-patent biological drugs.
 
2
IMS Health refers to doses as “standard units.”
 
3
These values were calculated by multiplying the number of packs sold of each product by the corresponding prices on a quarterly basis. For these calculations, IMS Health relied on the latest prices in each quarter from validated sources, such as government price lists and wholesaler invoices, excluding value-added taxes.
 
4
If sales of either <1,000 doses or < €1,000 were recorded in a country for a drug, we decided a priori to exclude the sales figures for that country, as was done in previous studies. Those values may reflect data-entry errors or inconsistencies in reporting across countries.
 
5
For the common sample of 110 active ingredients, the average number of grams of active ingredient per dose ranged from 0.09 grams in Sweden to 0.19 grams in Spain.
 
6
For ease of comparison to the other results, all prices are expressed in relation to those in Germany (index value = 100).
 
7
National government authorities in Denmark and Sweden operate tender-like systems: the relevant authority in each country asks drug makers to offer their best prices, and, in most cases, the cheapest products are the only ones which public payers will reimburse. This bidding process is repeated every two and four weeks in Denmark and Sweden, respectively. Payers in Germany and Spain also tender for generic drugs, but the tender results were kept confidential in 2013. The data, therefore, did not reflect tendering outcomes in either country.
 
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Metadata
Title
A comparison of generic drug prices in seven European countries: a methodological analysis
Authors
Olivier J. Wouters
Panos G. Kanavos
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2184-5

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