Next year, Finland will cut spending on pharmaceuticals more than ever before. But effective pharmacotherapy improves the treatment of various conditions.
Accurate and timely pharmacotherapy forms the basis of medicine, while pharmaceutical research and developments in medical treatment will improve the treatment of many diseases. When spending cuts start to take effect and Kela’s pharmaceutical reimbursements are reduced by as much as EUR 134 million, will pharmaceutical therapies and research be in danger?
Markku Mäkijärvi, Chief Medical Officer at HUS, considers the matter from the viewpoint of specialised health care:
“Savings in outpatient care may result in an increasing need for specialised health care in future. If a patient cannot take effective medicines for financial reasons or has to underdose them, this will gradually increase the number of complications and consequently the need for medical treatment.”
According to Mäkijärvi, it is a big mistake to cut spending on new and more effective but slightly more expensive products, such as the latest diabetes medicines.
“This can result in a poorer response to treatment later. And when the patient starts to suffer from associated diseases, this will result in even higher costs.”
Markku Mäkijärvi says, however, that so far there is no actual research data on the cutbacks in outpatient care and their impact on specialised health care. But he points out that in large health care units such as HUS, the use of new and expensive pharmaceuticals is always carefully monitored.
“We make monthly reports on the use of various products. And we also use competitive procurement, which decreases our pharmaceutical costs by EUR 5 to 10 million per tendering period.”
Safeguarding pharmaceutical development
The cutbacks planned for 2017 will be the biggest reduction of expenditure in the history of Finland. Pharmaceutical costs will be cut by a total of ten percent. Sirpa Rinta, Director of Pharmaceutical Policy at Pharma Industry Finland, however, is not overly concerned about the effects of the cutbacks on patient care.
“Some of the savings will be targeted at the rationalisation of pharmacotherapy and reduction of pharmaceutical waste. There will also be an emphasis on price competition, which will reduce costs for patients.”
According to Rinta, the positive side of the planned savings is the fact that the expiry of patents of biological medical products and the price competition on biosimilars will be very useful in pharmaceutical policy.
“In addition, pharmaceutical companies and the Ministry of Social Affairs and Health’s Pharmaceuticals Pricing Board can agree on the price of a new product and further research in order to make new medicines available to patients faster than before.”
But what worries Rinta is how the cutbacks will affect pharmaceutical research. At worst, they will reduce the opportunities for the development of research and treatment, she says.
“The plans for 2017 include suggested savings that would compromise the security of patent protection.”
Exemplary stroke treatment
Mäkijärvi points out that without high-quality pharmacotherapy, there would be no success stories in Finnish health care. One of these is stroke treatment. In this area, Finland is the world leader.
“Cerebral infarctions are a good example where the timely administration of effective pharmacotherapy will result in a maximal effect. This is a very time-critical condition, and poor end results are very expensive.”
For three consecutive years, HUS has been ranked the best provider of stroke treatment in the world. In addition, HUS has a service called Telestroke that provides consultation in stroke thrombolysis for a dozen central hospitals throughout Finland. Among university hospitals, Helsinki University Hospital also provides the least expensive treatment as regards the total costs of hospital and outpatient care and prescription medicines during the first year after the stroke. At the Helsinki University Hospital, the total sum per patient is about EUR 18,000 and at the Tampere University Hospital it is about EUR 25,000. Effective emergency treatment is worthwhile as the lifelong health care costs of stroke in Finland is estimated to be EUR 80,000 and annual, nationwide costs EUR 1.1 billion.
“This should be kept in mind when considering cutbacks,” Mäkijärvi says.
Sirpa Rinta agrees.
“Pharmaceutical development is vital simply because the selection of medicines is not yet ready. We will also need research on the treatment value or effectiveness based on various registers. And let’s not forget that pharmaceutical research also creates jobs and new investments.”
Why invest in pharmaceutical treatment and development?
- New products are needed for conditions that so far lack pharmaceutical treatment. Products already on the market will also require further research to receive data on their value in practical clinical work.
- Pharmaceutical research creates jobs. The current Government has confirmed the Health Sector Growth Strategy for Research and Innovation Activities which emphasises the operative environment of pharmaceutical companies and their employment opportunities.
- Besides jobs, pharmaceutical research and development also bring investments to Finland. Effectiveness research and genome research will also create new opportunities.
Text: Essi Kähkönen
Photo: Heli Blåfield