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 for prescription pharmaceuticals with competition. This is once again confirmed in TLV’s annual international price comparison report. For pharmaceuticals not exposed to competition, Swedish prices are overall in line with other countries.

For pharmaceuticals without competition, Sweden's prices have fallen by around 17 percentage points between 2014 and 2019 compared to European countries. About 60 per cent of this change is due to exchange rate fluctuation, that is because the Swedish krona has become weaker, and about 40 per cent is due to changes in list prices. Of the 20 countries in the comparison, 11 countries have higher relative prices than those in Sweden.

For pharmaceuticals with competition, Swedish relative prices have risen in recent years compared to other countries. However, it is once again confirmed that Sweden, together with Denmark and the Netherlands, have the lowest prices in relation to other European countries for these pharmaceuticals. The possibility to adjust prices are greater as a result of the design of Sweden's product-of-the-month system. The prices are allowed to vary under a ceiling price. This means that if the value of the Swedish krona depreciates, pharmaceutical companies can raise their prices to compensate for exchange rate losses. A weaker krona does not lead to relative price reductions in the same way for Sweden's part of the segment pharmaceuticals exposed to competition.

Swedish relative prices are higher for pharmaceuticals that are between 5 and 15 years old

Prices for new pharmaceuticals in Sweden are in line with other countries at launch. However, during the period when pharmaceuticals have been the market between 5 and 15 years, Sweden's prices are higher than average. The reason being that prices are falling in other countries but not in Sweden. For pharmaceuticals that are 15 years and older, the price level is significantly lower than the average. The reason is the efficient competition in the generic substitution system.

Older pharmaceuticals that are not considered substitutable have higher prices

This year's report highlights differences in price broken down by different pharmaceutical groups. ADHD and antiepileptic pharmaceuticals have relatively high prices in Sweden. One possible explanation is that, for various reasons, the generic substitution is limited in these groups.

About the report

TLV monitors and analyses the development of pharmaceutical prices in Sweden and internationally. The international price comparison report is part of TLV's mission to follow developments in the Swedish pharmaceutical market in an international perspective and is the sixth report of its kind. The analysis is based on national list prices at the AIP level (the pharmacy's purchase price). The analysis compares the price level of pharmaceuticals used in Swedish outpatient care with 19 other European countries: Belgium, Denmark, Finland, France, Greece, Ireland, Italy, Netherlands, Norway, Poland, Portugal, Switzerland, Slovakia, Spain, UK, Czech Republic, Germany, Hungary and Austria.