Pricing and reimbursement of pharmaceuticals in the Czech Republic and Sweden

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Abstract
Objectives To describe and compare price regulation and reimbursement in the Czech Republic and Sweden. Methods Legal documents, government reports, statutory information, annual reports and scientific articles were searched using the keywords: pharmaceutical market regulation, drug policy, drug pricing, drug reimbursement and patients’ participation in costs concerning both countries. Approaches to regulation and regulatory steps concerning prices were compared between the countries. Main outcome measure (i) Institutional responsibilities in pricing and reimbursement of pharmaceuticals; (ii) principles of patients’ participation in costs on pharmaceuticals. Results Substantial differences were found in terms of pricing. In the Czech Republic, the Ministry of Finance sets maximal prices for pharmaceuticals whereas in Sweden there is a process of price regulation combined with reimbursement decisions taken by the Pharmaceutical Benefits Board. Together with a system of state-owned pharmacies, this ensures that drug prices in Sweden are fixed at the same level throughout the country. In the Czech Republic, prices may differ, since only maximal price levels are set. In both countries, decisions about reimbursement are taken at the national or state level whereas insurance funds or county councils are responsible for covering costs. The private share of pharmaceutical expenditures is substantially lower in the Czech Republic, even though there is no maximal level for patient’s co-payment, as there is in Sweden. Conclusion Differences in price setting and some other regulations of the pharmaceutical market were found. Both systems are designed to promote rational use of pharmaceuticals; and are based on social solidarity.