The price of medicines are crucial for many groups of interests, above all, the patients. In case of medicines put on the reimbursement list the price instrument is essential also to the State as well as to medicines’ manufactures to whom the proper price is a key factor generating profits for their business. Statistics related to medicines’ prices from Eurostat resources in 2005 show undoubtedly they are at the lowest level among EU countries as well as in European Economic Area (EEA). In the other hand it does not change the fact the share of public funds in refunding is decreasing since 2003. That encroach the patients’ budgets as they pay extra for the refunded medicines.

 

The price of the medical product being paid by patients depends on many factors. Among the most important, they are:

-          legal regulation adopted by the legislator or other bodies issuing regulations;

-          the market mechanism, e.g. stronger competition in a relevant market sector forcing to reduce the price; 

-          sale and distribution method (Internet contra traditional retail);

-          the medicine origin (in relation to whether it comes from parallel import);

-          the role of promotion carried out by pharmacists and doctors;

-          the level of expenditure planned by pharmaceutical companies in their marketing budgets; 

 

The fact is that medical products delivered to patients by mail-order or through parallel import are several or a dozen or so percent cheaper that those purchased in a traditional way. These means of acquiring are in force because of lawmaking judgements of Court of Justice of European Communities, who used to pose a judgements stating that the ban of sale through mail-orders or parallel imports are contrary to the main rule of EU Treaty – free movements of goods.

In order to enable the patient to purchase the medical products at lower price it is essential to strengthen market mechanisms –  higher amount of products being equal in therapeutic effect will force other market player to reduce the price. This issue was stressed out by the European Committee in a preliminary report dated on November 28, 2008 on patent protection of original products and access to generic products market.

 

Basic matter related to medical products price on the most popular patients diseases (e.g. circulatory system) refers to mechanism of setting the price for refunded products. There are two basic mechanisms of medicines price establishing in Europe and somewhere else in the world, so called: fixed price system and free price system. However there are also mixed systems where, like in Great Britain, the price determined under free price system is influenced by various factors limiting expenditure of State Treasury towards refunding.

Nowadays in Poland in regard to refunded medicines the fixed price system is now in force. The minister of health department in co-operation with a minister of finance department determines in a decree what are the fixed prices and the allowable level of margins. Moreover, both the price system and margin are established as maximum thus those leading the medicines business – wholesale or retail – may compete by decreasing prices or margins as well as by other marketing instruments (loyalty programs, commercial discounts, club cards or points card etc.) beneficial to patients.  

Among the latest changes presented by the Ministry of Health in the project of amendment to Pharmaceutical Law Act and several other acts ( including the Act on prices) relating directly to prices establishing rules,  the systems modification has been proposed. The proposal points to introducing fixed price and margin system, whereas the administrative body shall establish the refunded part of a price and a stable rate of margin for wholesale and retail. It is  assumed that shall cause a decrease at the medicines’ prise and  manage to eliminate so called pharmacy tourism, i.e. searching by a patient the pharmacy offering the medicine at the lowest price.

As it is generally believed the project may infringe the constitutional rule of freedom economic activity as well as competition regulations. There is a risk that the proposal will bring not only ambiguous regulations and vague justification to the project, but also the results opposite to those had been expected. The outcomes the governors wish to achieve are able to be realised by means of other instruments, more simple legal mechanisms than those planned in the project of amendment.