2023-10-04 03:30:26
A royal decree modifying the public procurement rules for the purchase of medicines by hospitals should facilitate access to cheaper medicines.
Three or four years ago, very few so-called “biosimilar” drugs were used in hospitals. “Little by little, we managed to convince doctors, and their use progressed,” explains Marie-Dominique Wouters, head of the pharmacy department at the Saint-Luc University Clinics. According to Inami data, biosimilars represent 40% of biological drugs used, she says. “But in their purchasing policy, hospitals still use this type of medicine too little, or with difficulty.which leads to a additional cost for Social Security“, estimates the Minister of Health, Frank Vandenbroucke.
A biosimilar medicine is the generic equivalent of biological medicines used in hospitals. “This category of drugs, in which we find treatments once morest cancer or autoimmune diseases, hormonal treatments, drugs to treat certain chronic diseases such as rheumatic fever, Crohn’s disease, hemophilia, generally has a high cost, especially since it is taken for a very long time”, explains Marie-Dominique Wouters. Patients come receive their injection in a day hospitalor their treatment to be taken at home or directly in the hospital.
Greater use of the biosimilar version would make it possible to reduce costs for Social Security and thus free up margins to reimburse more innovative treatments.
Every year, health insurance devotes 1.7 billion euros to reimbursement of biological medicines purchased by hospital institutions. An amount which might be reduced if competition between manufacturers worked well, estimates Frank Vandenbroucke. He therefore issued a royal decree in order to make the market more dynamicby removing certain obstacles present in public procurement rules in order to allow more companies to participate in these markets, thus increasing competition and making it fairer.
The barriers are too big and the lack of fair competition makes the market unattractive for biosimilar drug manufacturers. They struggle to compete for public tenders. The lack of competition also means that expensive drugs keep their prices high. If a sufficient number of companies participate in the public auction, the probability is greater that prices will fall, explains the Vandenbroucke firm.
“The purpose of the Public Procurement Act is precisely to ensure that public funds are spent in the most rational way possible.”
Reduce the risk of shortages
But the consequences are not only financial. The lack of dynamism in the market also generates an impoverishment of supply: the number of actors is more limited, which makes the country more vulnerable to drug shortages in the event of a supply problem. The shortage cannot in fact be filled with biosimilar drugs. “The law on public procurement aims precisely to guarantee that public funds are spent in the most rational way possible,” underlines the Vandenbroucke cabinet.
Concretely, three measures are taken: hospitals must award or conclude the public contract in a period of nine months following the date on which a biosimilar is reimbursable and available on the markete. As soon as there is a new player, hospitals are no longer bound by the old contract. The duration of the public contract is limited to two years, renewable up to a maximum of four years. Certain criteria favoring reference drugs too much for public procurement have been removed. The system will be evaluated every two years.
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