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Confidential agreements and medicines out of reach for millions. Journalism for a changing Europe. About Deadly prices Confidential agreements and medicines out of reach for millions. Confidential agreements, secret discounts and the power of big pharma. Investigate Europe examines and exposes the continent's hidden drug pricing system. About Deadly prices. Patients suffering from cancer or other serious diseases rarely realise that their fate can depend on secret price deals struck between state officials and pharma executives. Despite the discounts, governments are often charged extortionate fees for life-saving medicines — or they are unable to access them altogether, an eight-month investigation by Investigate Europe and its partners has found. Patients are suffering needlessly because companies pick and choose where it is more profitable to launch their drugs. Drugmakers demand higher prices each year, often with discounts already priced in, says Joerg Indermitte from Switzerland's Federal Office of Public Health. We never had such a high price. Although only patients are treated with this new drug, it is extremely expensive. Rich nations generally pay less than those in central and eastern Europe for certain drugs, the investigation finds. It reveals an alarming gulf in access across the bloc to many innovative medicines, while drug firms rack up vast profits from healthcare systems. The reason is simple: dozens of countries set their prices by looking at what other states publicly say they pay — be it cancer treatments with list prices in six figures or rare single-dose drugs marketed in their millions. In reality, a parallel system exists. The European Medicines Agency approves certain categories of drugs for use across Europe. Companies then choose whether they want to market a drug in a country or not. The official price is set by each country separately and then individual negotiations begin to agree on any secret discounts. Then, over time, companies discretely return the difference between the official price and the real, negotiated price. In bigger markets, the rebates are larger, and the amounts of public money temporarily loaned to industry even higher. Zolgensma, a Novartis drug, is among a number of highly priced medicines. In the Netherlands, the part of the national hospital budget spent on these drugs has risen from 0. Norwegian authorities say they had to rebuild their database to give room for more zeroes in million-figure prices. Ultimately, a confidential rebate was agreed in The firm disputes this, saying that prices are not determined by production costs, but by the investment made in their development, the risk undertaken, and their value to the community. The medicines have been lauded for helping patients with the rare disease that progressively clogs the lungs and can lead to early death. Vertex Pharmaceuticals, the US biotech firm, has a monopoly on cystic fibrosis treatments. Analysis of corporate records and budget and health data from national authorities provides for the first time a glimpse into the disparity in what countries pay for these life-saving medicines. In western Europe, Investigate Europe compared Vertex's local revenues to the official number of patients taking the company's drugs in In comparison, the average expenditure per patient in some central and eastern European countries appears higher. Lithuanian authorities have spent years trying to negotiate with Vertex amid mounting pressure from the media and patient groups. She posted a video online, begging Vertex to give her Kaftrio. There should be no discrimination in the EU. Seeing how effective they were, she crossed the border for good. Far cheaper than the Vertex list price, but still more expensive than elsewhere in Europe. Monika Luty was forced to leave Poland in because Kaftrio was not reimbursed there. Monika Luty. It added that over the past decade more than 70 per cent of its operating budget was spent on research and development. When asked about confidential pricing, the European Federation of Pharmaceutical Industries and Associations, did not directly answer the question whether richer countries are paying more than poorer ones. A typical strategy to maintain the secrecy status quo is the threat to boycott markets. They wanted to present results without divulging any protected data about specific deals. Yet after pressure from the Belgian Pharmaceutical Association, a watered-down study was released, excluding any analysis of those deals. The study did however reveal that the association had threatened to sue prior to publication. When a big Swiss drugmaker pushed for a higher price in Austria, Clemens Auer alleges that a representative reminded him of the investments they had made there, implying that those were at risk if a favourable deal was not agreed. Denmark and Germany, two countries that allow companies to initially set official prices freely, are usually the first entry points in Europe. Meanwhile the initial high prices are used as reference by others, while setting their own official prices. What happens next in the two countries is shrouded in secrecy. Danish hospitals procure the most expensive medicines with confidential discounts, but these deals do not appear on Euripid, the European pricing database, Danish officials say. Germany is even more opaque. It vetoed a World Health Organisation resolution on price transparency and it is not even part of Euripid. A pharmacist working for a Hungarian subsidiary of a multinational drugmaker puts it bluntly: 'For a company like Novartis or Pfizer, the Hungarian market is a rounding error. Data collected from across Europe reveals that several EU Countries do not have direct access to a number of critical medicines. Investigate Europe found that Hungary is among several states locked out of access to critical medicines. These drugs, according to the scientists, have a 'significant' or 'considerable' additional benefit to existing therapies. They included treatments for conditions including breast cancer, leukaemia and cystic fibrosis. Data collected from across Europe reveals that in six EU countries one in four of these important medicines is missing. Without purchasing agreements between countries and companies, which are the basis for reimbursement, health authorities have to resort to other costly methods to obtain a drug, or miss out on access altogether. The situation is particularly dramatic in Hungary, where 25 out of 32 medicines are not generally reimbursed, and in Malta and Cyprus, where 19 and 15 medicines respectively are similarly unavailable. Patients in Cyprus and Hungary can get some drugs by applying for individual access — but often at exorbitant costs to the state. In the Baltic states and Romania, a high number of important medicines are also unavailable. Even when medicines are made available to smaller states, prices can be excessive. He is appalled that the EU allows industry to treat its members so differently. Without the slightest consideration, the EU is giving up on its sole advantage, its size. The one time major companies negotiated EU-wide was for Covid vaccines. Further north, the Beneluxa collaboration — Austria, Belgium, Ireland, Luxembourg and the Netherlands — has negotiated prices for a few high-cost drugs, mostly with small firms. Two negotiators involved said bigger companies are reluctant to join. It showed that if pressured, industry can conceivably agree to not play one country against the other. But prices again were secret. Meanwhile, the suspicion that every time there is a confidentiality agreement, someone else is being ripped off, was proven right when the price of the AstraZeneca Covid vaccine was leaked. In South Africa it was double that of the EU. It includes no measures to tackle secrecy or confidential prices. Even an attempt to reduce market exclusivity of pharmaceutical firms was clipped by industry and member state lobbying. Yet when contacted, Euripid refused to provide any data on the rising number of confidential agreements between states and pharmaceutical companies. Now the veil of secrecy could become even thicker. A new law for 'Medical Research' is under discussion in the German Parliament. If it passes, every time authorities order a price cut because a drug does not perform as promised, the rest of the world will not know. Industry will be thrilled if it happens, says Josef Hecken, head of the national committee for approving new drugs. Cross-border stories from a changing Europe, in your inbox. By signing up, you agree to our Privacy Policy.

Psychedelics Are Cheap. Psychedelic Treatment Is Not.

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Psychedelics hold immense potential to address an array of conditions that are otherwise challenging to treat, but accessing these therapies can be costly, which means that potential benefits will be stratified along the lines of socioeconomic status. This is an acute concern, because many with conditions that psychedelics may help to treat — such as post-traumatic stress disorder , postpartum depression , treatment-resistant depression , and alcohol use disorder — lack the resources to pay for effective health treatments. Psychedelics themselves are not very expensive. But that is just the cost of the actual drugs. In order to limit risks associated with these substances, patients may need to do so in a clinic with a range of safety precautions. That requires having staff on hand for a long period of time to ensure the safety of vulnerable patients submitting to a disorienting experience. Many worry that profit-seeking entrepreneurs will see an opportunity and drive those prices even higher. Ketamine, which had a rocky rollout as an antidepressant treatment, showcases the complexities in this space. The FDA approved S-ketamine to treat depression in Through Joyous, customers can legally and relatively affordably get ketamine treatment to take in the comfort of their own homes. This price disparity undoubtedly makes at-home use attractive to many patients. Yet, experts fear that using ketamine therapy at home for depression, without the oversight and guidance of a trained clinician, is potentially ineffective, dangerous, and subject to abuse. While ketamine overdoses compared to other drugs like MDMA are relatively rare , traumatic injuries sustained by those under the influence of the drug are not. With more patients taking the drug away from the safety precautions of a clinic, experts worry those numbers might increase. This dichotomy illustrates the difficult decision patients face between costly psychedelic-assisted therapy and the more affordable option of taking these drugs at home. Some may not have a choice at all, given the exorbitant cost of psychedelic-assisted therapy. On the supply side, it comes as no surprise that Field Trip had to close several locations and sell off many of their assets over the past year. There are few obvious solutions to bridge the disconnect between patient need and ability to pay for these treatments. Patients may be more willing to purchase treatment plans if insurance covers them , but insurers are hesitant to fully cover psychedelic-assisted therapies. Still, to me, the most promising route to access is probably through FDA approval which means more clinical trials and expanded insurance coverage. Some novel approaches have already been implemented, and the rollout of FDA-approved MDMA-assisted therapies which some predict will come as soon as next year will likely inspire more ingenuity to increase access. Yet, insurance coverage alone is an imperfect solution because millions of Americans have no health insurance. Yet, inroads have been made by organizations such as the Sage Institute to bring access to these drugs, and their potential, to those most in need. If prices remain exclusionary in this field, the public may view psychedelic therapy as a luxury for the rich — and perceptions may well remain quite negative. If, however, we can figure out a way to get psychedelic therapy to reach those most in need, we may well be on our way to a true paradigm shift. If you have any innovative ideas, I would love to hear about them in the comments below. Vincent Joralemon is a law student J. His current research focuses on tensions between the patent incentive system, the FDA approval process, and insurance carriers. You must be logged in to post a comment. This site uses Akismet to reduce spam. Learn how your comment data is processed. By Vincent Joralemon Psychedelics hold immense potential to address an array of conditions that are otherwise challenging to treat, but accessing these therapies can be costly, which means that potential benefits will be stratified along the lines of socioeconomic status. Ketamine: A Cautionary Tale Ketamine, which had a rocky rollout as an antidepressant treatment, showcases the complexities in this space. No Simple Solution This dichotomy illustrates the difficult decision patients face between costly psychedelic-assisted therapy and the more affordable option of taking these drugs at home. Vincent Joralemon Vincent Joralemon is a law student J. Leave a Reply Cancel reply You must be logged in to post a comment. Sign up for our newsletter Subscribe.

Maggiore buying MDMA pills