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Swedish substitution system quickly lowers pharmaceutical costs

The Swedish system of substitutable pharmaceuticals with a ‘product-of-the-month’ quickly brings down the prices for prescription pharmaceuticals. This is once again confirmed in TLV’s annual international price comparison report. For pharmaceuticals not exposed to competition, Swedish prices are in line with other countries.

“Sweden, Denmark and the Netherlands have significantly lower prices on pharmaceuticals that are subject to competition (in the ‘product-of-the-month’ system) compared to other European countries,” says Pontus Johansson, senior economist at TLV.

These countries generally steer sales towards the product with the lowest price when there is a chance to make substitutions. New products are constantly added to the ‘product-of-the month’ system as patents lapse and competition arises. The price drops immediately after competition is introduced. Sweden has reinforced its position among the countries with the lowest prices.

Pharmaceuticals not exposed to competition

When it comes to non-substitutable pharmaceuticals, primarily patented originals, Swedish prices are among the nine most expensive countries of the 20 included in the comparison. The Swedish prices have dropped since 2014, relative to the other countries. Between 2014 and 2015, Swedish prices were lowered through a number of extensive reassessments. The change between 2016 and 2017 is fairly small, with Swedish prices becoming marginally higher compared to other countries. Prices in Sweden are still in line with those of other countries.

About the report

TLV monitors and analyses pharmaceutical prices, in Sweden and abroad.

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 fourth report of its kind.

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

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

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 2017. Pharmaceutical data has been grouped by substance, dosage form and strength.


13 februari 2018