Institute for Pharmacological Research Mario Negri IRCCS, Ranica, BG, Italy.
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Intern Emerg Med. 2022 Jun;17(4):945-948. doi: 10.1007/s11739-022-02960-8. Epub 2022 Mar 18.
A price stems from the intersection between supply and demand curves in any common market. However, there are special markets where consumers do not pay for goods directly, and prescription drugs are a well-known example in healthcare. Drugs are mainly funded by public expenditure in well-established welfare systems like those of the Western European countries. However, the present era of austerity in public funding has made financial resources scarce in most European nations. Currently, the leading tendency for pharmaceutical pricing in Europe is direct negotiation with pharma companies. However, these negotiations are administratively burdensome, with costs not necessarily offsetting savings. Moreover, since any trade negotiation implies some degree of confidentiality to be effective these strategies are scantily transparent. When prices are set for many products through unavoidably arbitrary decisions, the final consequence is an irrational allocation of financial resources. Here, we raise a proposal to restore a reasonable balance between public equity objectives of health authorities and private profit incentives of the pharma industry in Europe, switching from pricing to budgeting. The underlying rationale of our proposal is to stop setting arbitrary prices in a context of market failure.
价格源于任何常见市场中供给和需求曲线的交点。然而，有些特殊的市场中，消费者并不直接为商品付费，而处方药在医疗保健领域就是一个众所周知的例子。在西方发达国家的福利体系中，药物主要由公共支出提供资金。然而，当前公共资金紧缩的时代使得大多数欧洲国家的财政资源变得稀缺。目前，欧洲药品定价的主要趋势是与制药公司进行直接谈判。然而，这些谈判在行政上负担沉重，成本不一定能抵消节省的费用。此外，由于任何贸易谈判都需要一定程度的保密性才能生效，因此这些策略的透明度并不高。当通过不可避免的任意决策来确定许多产品的价格时，最终的结果是财政资源的不合理配置。在这里，我们提出了一个建议，即在欧洲，从定价转向预算，恢复卫生当局的公共公平目标和制药行业的私人利润激励之间的合理平衡。我们建议的基本原理是停止在市场失灵的情况下设定任意价格。
