TLV’s annual international price comparison of pharmaceuticals

The price of prescription pharmaceuticals in retail pharmacies in Sweden has fallen compared to other European countries since 2014, and is currently among the lowest. This can be attributed to the weakening of the Swedish krona in relation to the euro during this period. These are the main conclusions in the annual price comparison report published by the Swedish Dental and Pharmaceutical Benefits Agency (TLV).

In the report Sweden's pharmaceutical prices are compared with 19 other European countries. The report has been published annually since 2014. According to the report, Sweden's relative pharmaceutical prices are the fifth lowest for pharmaceuticals without generic competition and the lowest for pharmaceuticals with generic competition. Between 2014 and 2022, Sweden's pharmaceutical prices have fallen in relation to prices in other countries, particularly for pharmaceuticals without generic competition, due to the weakened Swedish krona.

– Since the pharmacy purchase price (AIP) is set in Swedish kronor, a weaker Swedish krona exchange rate leads to lower Swedish prices in relation to other currencies. However, if the effect of the changed exchange rate is removed, the Swedish prices remain largely unchanged over time compared to other countries, says Pontus Johansson, head of unit at TLV.

Lower price dynamics before patents expire

The analysis also shows that Sweden has relatively low prices at market introduction, which tend to remain unchanged until the patent expires in year 15. Prices in other countries tend to fall to a greater degree than in Sweden until year 15. The price dynamics in the Swedish system between introduction and patent expiry therefore tend to be smaller compared to other countries on average. After 15 years on the market, which roughly corresponds to the time for a pharmaceutical patent to expire, Swedish prices clearly decrease compared to other countries.

Sweden’s generic substitution system lowers the prices

Sweden's system of substitutable pharmaceuticals with a 'product-of-the-month', which promotes price competition, helps to keep prices down for pharmaceuticals older than 15 years. This system is similar to those in the Netherlands and Denmark. During the entire period from 2014 to 2022, Sweden's prices for pharmaceuticals in the 'product-of-the-month' system have been among the lowest in Europe. In 2022, Sweden's prices for pharmaceuticals with generic competition were 53 percent lower than the average for the other 19 countries.

The international price comparison report is part of TLV's mandate to monitor the development of pharmaceutical prices in Sweden and internationally. The report is based on national list prices at a pharmacy purchase level and reports the results from the analysis based on price and volume data for the first quarters during the period from 2014 to 2022 in Sweden compared to 19 other European countries, including Belgium, Denmark, Finland, France, Greece, Ireland, Italy, Netherlands, Norway, Poland, Portugal, Slovakia, Spain, United Kingdom, Germany, Hungary, and Austria.