A Green Pricing and Reimbursement System

I have discussed green incentives and green criteria for pharmaceuticals several times before. See for instance these blog posts from 2011 Feb 23, Feb 8, Jan 18, and from 2010 Nov 12.

Going green...

Going green...

Today we took an important step in the process of ”greening the systems” for pharmaceuticals. LIF, the research based pharmaceutical industry in Sweden, had invited several stakeholders to a meeting called ”Miljöanpassade läkemedel – vad är det och hur når vi dit?” (rough translation would be: Green pharmaceuticals – what is it and how to get there?). Stakeholders represented in addition to LIF-colleagues today were Charlotte Unger from the Swedish MPA (Läkemedelsverket), Leif Lundquist and Niklas Hedberg from the Swedish Dental and Pharmaceuticals Benefits Agency (TLV), Cecilia Marlow from Swedish Pharmacy Association, Kenneth Nyblom from the Association for Generic Pharmaceuticals (FGL), Maria Azzopardi from the Swedish Environmental Management Council (Miljöstyrningsrådet), Siw Martini and Åke Wennmalm from Stockholm County Council (SLL), Karl Lilja from IVL Swedish Environmental Research Institute (IVL), and Joakim Larsson from Sahlgrenska Akademin.

Joakim L gave us first, as a background to today’s discussions and to create a ”sense of urgency”, a summary of the research he and coworkers have performed over the years in India, looking into the issue of releases from pharmaceutical manufacturing. Read for instance my blog post from Aug 16, 2010, to get a summary of the issue.

After that, Maria A presented the guiding document on environmental and CSR-criteria for public procurement of pharmaceuticals, developed by Miljöstyrningsrådet in collaboration with stakeholders. One comment given after the presentation was that the criteria presented in the guide might be suitable for publicly procured pharmaceuticals in the tender business, with all the different aspects that need to be taken into account based upon the EU directive on Public Procurement and the related Swedish regulation ”Lagen om Offentlig Upphandling”, but perhaps not for the rest of the pharmaceutical market. The guide is pretty much seen as an attempt to generate a ”fairly low bar” that most pharameceutical companies and products should be able to pass, in order to secure as many as possible tenders to be received by the procurement organisations. For the rest of the pharma market, i.e. products that are not part of the tender business, there should be a possibility to have higher ambitions and criteria that only some companies and products meet. Those companies and products would hence drive a continuous improvment over time in order to remain with their competetive edge and be granted the green incentives.

We had long and good discussions and making a long story short, and not going into any details on the different ideas around the incentives or the criteria, we agreed to the following:

- A new meeting to be held in end of September

- At that meeting working groups initiated today will present their ideas regarding

– criteria to be fulfilled in order to declare a company/product ”green”

– costs to be managed within the pricing and reimbursement system, or elsewhere, associated with different ”green incentives”

And already before that, Swedish MPA will have presented a report on their governmental commission regarding potential incorporation of environmental requirements into GMP. The report is due end of June. This will of course also be integrated into the discussions prior to our next meeting in September and during that meeting. Another important piece to be integrated into these discussions is of course the National Pharmaceutical Strategy, which will be presented in June as well. Read more about the strategy here on my blog (e.g. Dec 12, 2010) or via this link.

I am already looking forward to the next meeting with the group of stakeholders but also of course to the work process we have in front of us. It will be very interesting to see if we manage to find relevant and reasonable criteria to establish a common understanding for ”what is a green pharmaceutical”, and to find incentives interesting enough for industry and within a reasonable cost frame that is acceptable to a payer. And also to find the solution to the obvious question: Who is that payer? Additionally I really hope that we manage to describe the roles and responsibilities of all the different actors on this new green pharmaceutical market, i.e. the manufacturer, the pharmacies, the patients and customers, the payers and the agencies.

We have embarked on a Green Journey – that’s for sure!

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