The scandal with the high prices of medicines paid by National Health Insurance Fund (NHIF), left on the second position the battle for market share between the two wings of the pharmaceutical industry. Associations of generic and research industries – BGPharmA and ARPharm, already tested the situation and met with the new health minister Desislava Atanasova as well as agreed to some concessions. At the same time, through various methods, they showed strong intention to maintain and thus increase their presence on medication markets. Apparently their goal is to use the negotiations and strengthen their positions before the new management of both the ministry and the healthcare fund. How this quiet war may end is still early to say because there are zillions of interests involved. However, this will be an important test for the government. Its reaction will express its proneness to support one or another side in its medications policy. Both sides have their well-reasoned arguments as well as support by the political lobbies.
On the first place, generic companies are apparently seeking ways to make use of the favorable moment and expand their presence in the Positive Drug List, which is still dominated by the originals. In this respect, BGPharmA, in line with the tone of negotiations, proposed a package of measures to optimize the expenditures of the healthcare fund on these drugs that are 100 percent covered by it. Among them stands out the desire of businesses to speed up patientsrquote access to generic drugs by reducing the period of price formation and enlisting a drug by up to 30 days. Another request is to encourage doctors to minimum safe generic for socially significant diseases.
According to the association in 2011 the health insurance fund spent 76 percent of its funds on drugs to originals and 24 percent on generic drugs, but in 2012 this ratio is expected to reach 85 and 15 percent respectively. Generic manufacturers will strive to increase their share, informing patients and the public that their medications are four times cheper, while their therapeutic effect is similar to the originals. President of the Bulgarian Generic Pharmaceutical Association Rossen Kazakov said that in order to reduce drug prices in the country, the state should encourage market competition.
For their part, original manufacturers are trying to focus the discussion to a different question. According to ARPharM companies last year healthcare insurance fund paid
higher prices for 36 drugs for different types of cancer because the legislation did not allow for negotiation of discounts for drug analogues that are supplied by more than one manufacturer. NHIF will save nearly BGN7 million if it changes the rules of the game for the generic industry, representatives of the union believe. The association also points out that according to the European statistics prices for nearly 6,000 prescription drugs in Bulgaria are among the lowest in Europe. For the end user they are expensive primarily because of the charging 20 percent VAT tax.
Average price per package of medications sold in Bulgaria is EUR3, in producer prices, as compared to EUR4.2 euros in Romania, EUR5.9 in Hungary, EUR8.1 in Spain, EUR9 in Greece and EUR17.1 in Germany. Therefore, additional administrative measures to reduce manufacturing costs for all marketed drugs are not necessary, say representatives of the original pharmaceuticals.
