Article published in medical journals 9/12/2009
The current design of the pricing system called Reference has served to gradually reduce the price of drugs for which there are generic and in this regard, it has been a measure to assess positive.
The reality is that there is little or very limited price competition at the retail price, which pays the public and patients, which contrasts with strong competition between laboratories at the level of laboratory sales price The pharmacy paid as highlights a recent report by the Catalan Autoritat Competition (http://acco.gencat.cat/). This strong price competition from sale of the laboratories is manifested in the form of very high discounts on purchases made by pharmacies, ranging between 10% and 70%. This is a clear indication that the current reference price system in force in Spain does not move quickly the effect of price competition by late payers (the NHS and patients).
This situation has two outstanding issues from the point of view of competition. The first is that it reduces the choice of patients and the pharmacy has an incentive to provide those generics for which you get more discount. The second is that competition is distorted: it is easy to see that the laboratory that can offer greater discounts to pharmacies is one that has a higher price, provided that it does not exceed the reference price. This is precisely the opposite of what should happen a competitive market. This problem is not specific to Spain, has been well described and studied before in many countries and most of them have adopted regulatory changes to mitigate the problem.
should bear in mind that this problem is due to poor design of regulation and not the behavior of economic actors (laboratories and pharmacies).
There are several possible reforms to promote healthier and more efficient competition in the generics market. The first is to expedite the reference price system: automatic substitution bi-product of lower prices in every moment of time with mandatory substitution and avoidable copayment (the patient, if you want, choose a more expensive equivalent drug, but pay the difference out of pocket).
The second is the creation of observatories
information systems on the actual purchase price of the pharmacy and return them by the public sector an important part of the discount obtained.
And third, is to opt for the conduct of public auctions to determine one or more laboratories as preferred suppliers for each product by decoupling the compensation price pharmacy laboratory.
