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TLV's annual international price comparison of pharmaceuticals

The Swedish system of substitutable pharmaceuticals with a 'product-of-the-month' quickly brings down the prices of prescription pharmaceuticals. This is evident from the TLV's annual international price comparison. For pharmaceuticals not exposed to competition, Swedish prices are in line with those of other countries.

"Sweden belongs to a group of three countries, together with Denmark and the Netherlands, that has significantly lower prices for pharmaceuticals exposed to competition in a product-of-the-month system compared with other European countries", says Pontus Johansson, senior economist at TLV. "This applies to pharmaceuticals whose patent protection has expired, where the price index is on average 93 percent higher in other countries compared to Sweden".

The report shows that the difference in prices between countries for pharmaceuticals with competition fell somewhat between 2014 and 2015, only to increase again between 2015 and 2016, which strengthened Sweden's position in the group of countries with the lowest prices in Europe.

The analysis also shows that the Swedish substitution system quickly reduces pharmaceutical prices. Prices fall sharply immediately after competition arises.

In terms of volume, pharmaceuticals with competition constitute approximately half of the market and the product groupings that best explain why Sweden has a lower price level than other countries are those within the cardiovascular and nervous system fields. For cardiovascular diseases, the index is higher in all other countries, and for the nervous system, only Denmark, the Netherlands and Slovakia are cheaper. However, within these groupings, there may still be substances that are more expensive in Sweden.

Pharmaceuticals not exposed to competition

Regarding pharmaceuticals without competition, which predominantly consist of patented original pharmaceuticals, Swedish prices during the years 2016 and 2015 could be found among the eight countries with the highest prices of the 20 countries compared.

On average, Swedish prices are in line with those found in other countries. Swedish prices have fallen compared with other countries since 2014. Between 2014 and 2015, Swedish prices fell as a result of TLV making new decisions in several reassessments of pharmaceuticals already included in the benefits scheme. Changes between 2015 and 2016 are, however, minor.

About the report

The international price comparison report is part of TLV's assignment to monitor developments in the Swedish pharmaceutical market from an international perspective. It is the third report of its kind.

The analysis is based on national list prices at AIP (pharmacy purchase price) level.

The analysis compares the price levels of pharmaceuticals used in Swedish outpatient care with 19 other European countries: Belgium, Denmark, Finland, France, Greece, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Switzerland, Slovakia, Spain, Great Britain, the Czech Republic, Germany, Hungary and Austria.

The pharmaceuticals have been divided into segments based on the prerequisite for competition in Sweden; pharmaceuticals not exposed to competition and those exposed to competition, which includes all pharmaceuticals included as substitutes for the product-of-the-month in March 2016. Pharmaceutical data have been grouped according to substance, dosage form and strength.