Cost and utilisation of pharmaceuticals in Sweden.

Issues of efficiency, access, equity and cost have informed Swedish national policy toward pharmaceuticals for many years. While retail pharmacies have been owned and operated by a single state company since 1971, the manufacturing of pharmaceuticals has remained privately owned and operated. Costs to the health care system for pharmaceuticals have been rising 4-8% in the last several years, despite greater use of generic substitutes. Beyond price-reduction pressures created by the state retail monopoly, by reference pricing, by positive lists, and by an expanded system of capped patient copayments, the national government is considering plans to decentralise responsibility for all outpatients as well as inpatient drug expenditures to the 26 country councils.