Most citizens do not know what it means to have a public health system (SNS) that meets all the needs of any person, for example, medicines to treat any disease, whatever their price yet.
How much do the drugs you or I use cost? We must make a contribution that varies depending on the level of income and whether we are active or pensioners, but we do not know the real price of medicines taken from any pharmacy or collected free of charge by the services of pharmacy in our hospitals. There are some drugs whose prices are really crazy, especially the new ones.
According to the report Wyden-Grassley on United States Senate The initial price of a drug is established by the laboratory based on its calculations of the maximum that can be paid by patients or health services in different countries, based on the price previously established in the United States, which is free. When it was introduced to Europe it was usually done by countries that could pay a higher price, for example, Germany or Holland, then “forcing” other European countries to accept in prices.
In Spain the real price is set by negotiation between Ministry of Health and the corresponding laboratory through a confidential and opaque procedure. Recently a judicial decision from the Central Contentious-Administrative Court number 9 of Madrid, belonging to the National Court, at the request of CITIZENS A non-profit organization that fights against the opacity of public administrations, endorses for the first time the price and financing conditions of public medicines. The decision dismissed the appeals filed by Ministry of Health y Novartis with those seeking to continue to hide the price and financing conditions secretly negotiated for the drug Luxturna and clearly supports that the price and funding conditions of drugs are not private information and should be public to know “how public resources are used for drugs.”
Let’s look at some examples of the prices of new medicines in Spain. Let’s start with the most expensive which, fortunately, requires a small number of people. Zolgensma a drug indicated for the treatment of patients with spinal muscular atrophy (SMA) costs 1.94 million euros per patient, Spinraza a drug used to treat another type of spinal muscular atrophy costs 1.49 million euros per patient, Luxturna a drug used to treat children and adults with vision loss due to hereditary retinal dystrophy (a rare genetic disease of the retina) costs 688,896 euros per patient, Yescarta indicated for the treatment of adult patients with diffuse large B-cell lymphoma (DLBCL) and high-grade B-cell lymphoma (LBAG) costs 327,000 euros per patient, Kymriah used for the treatment of various hematological diseases (B-cell acute lymphoblastic leukemia, diffuse large B-cell lymphoma, follicular lymphoma) costs 320,000 euros per treatment, Takhzyro indicated for the prevention of recurrent attacks of hereditary angioedema costs €226,293 per treatment, Tecentriq used for the treatment of locally advanced or metastatic urothelial carcinoma costs between €17,000 and €71,000 per treatment.
Fortunately, these are rare diseases, but families who are unlucky enough to have one of their members suffer from one of them certainly cannot pay for these drugs with their own resources. , for example, happens to North American families whose majority cannot afford to pay it, pay them and no longer use it. In Spain, fortunately, the SNS pays for this type of treatment, which, do not forget, is paid with money from our taxes (for that, among other things, the taxes are worth it).
There are many more, more common diseases that affect a significant part of the population and therefore, although the prices of these drugs are lower, the total cost is very important. Let’s look at two examples.
In Spain, approximately three million people suffer from Chronic Obstructive Pulmonary Disease (COPD). The drugs used by a patient with COPD depending on its severity have an average annual cost between 940 and 1,457 euros. The estimate of the annual cost of COPD in Spain in 2014, according to the COPD Strategy document of the National Health System of the Ministry of Health, amounted to 750-1,000 million euros. In 2022, according to the CPI update from that year, will be 17.4% more: between 880 and 1,174 million euros.
Another common disease is diabetes. In Spain, in 2014, 2,939,000 patients suffered from it and it is estimated that in 2022 the number will be close to five million diabetics. The average annual cost of hypoglycemic drugs used by a patient is 281 euros, although in this case the pharmacological treatment of diabetes is not the most expensive, but the treatment of its complications. A patient with good control of their diabetes represents 883 euros per year in costs for the SNS, while those who are not well controlled can have costs of 2,133 euros per year. According to the 2013 SECCAID study, the direct costs of diabetes amount to 5,809 million euros per year, of which 2,143 million are due to the complications associated with the disease. In 2022, according to the CPI update since 2013, it will be 16.1% more: 6,744 million euros.
Health professionals who have the capacity to prescribe medicines should know the usefulness and value of the medicine we prescribe and the patients who use it should also know how much their medicines cost; Each of us is obliged to use it wisely. Perhaps in this way, each of us will value the privilege of having a National Health System that covers our drug needs regardless of their cost.