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The pharmaceutical sector in Norway has responded to recent
criticism levelled at the industry by healthcare authorities
related to increases in medicine shortages in the country. The
industry's position has generally held that the small size of the
pharmaceutical market, combined with the low drug prices that
manufacturers can obtain, is chiefly responsible for recent spikes
in shortages of certain medicines.
Norway operates a number of pricing and reimbursement (P&R)
mechanisms to ensure that the country maintains low drug prices in
relation to comparable Western European countries. This is having
an increasing effect in terms of rendering Norway a less attractive
market for suppliers. Norway's Pharmaceutical Industry Association
LMI also warns that there is a risk that the country will be
further de-prioritized in the event that supply shortages occur
elsewhere in the European region.
The industry association called for changes to be made to tendering arrangements for
"H-prescription" (outpatient prescriptions reimbursed by regional
health authorities). At present, H-prescription tenders mean that
only one supplier is selected for the duration of the tender
period. This can mean that no alternative supplier is available in
the event that delivery problems arise. To overcome this, the LMI
proposes that two suppliers should be selected for tendering
contracts. This would mean the lowest and second-lowest tendering
offers will be selected to supply the market.
Also, the LMI proposes changes to how Norway uses international
reference pricing (IRP). As such, the LMI suggests that Norway
should no longer reference the lowest price in three of the nine
reference countries in Europe that it uses. Rather, the LMI
suggests that Norway should reference the average price in all nine
IRP markets.
The proposals that have been brought forwards by the LMI would
result in slightly higher prices in Norway, but this would be
offset by increased security of supply. Policy-makers will consider
the policy measures, although realistically, it is highly unlikely
that the changes will be implemented in full or anything other than
a long-term timescale.
Posted 05 October 2018 by Eoin Ryan, Senior Analyst
