TALLINN - As the government ponders amendments to the law on pharmaceuticals, it appears that cheap medications will get cheaper, while the price of expensive drugs will likely increase for Estonian consumers beginning in 2005.
MP Andres Kork of Res Publica, who chairs the Estonian Medical Association, said the bill had not reached Parliament yet. "However we must pass it and must have the renewed law working by May 1. And we have all the opportunities to do so," said Kork, who is member of the social commission in Parliament.
Kork described the present law as "containing major flaws" and "lacking the EU requirements."
The amendments would oblige doctors to mark the effect of the drugs they prescribe for patients and force drugstore salespeople to offer the cheapest medication options according to the prescription. Doctors and drugstore workers would also be obliged to preferentially offer the drugs from the list of medications sponsored by the Estonian Health Insurance Fund, those that are the cheapest, according to Kork.
However, these measures would likely be implemented before May, as the Social Affairs Ministry plans to issue a related decree.
According to Social Affairs Ministry Chancellor Kulvar Mand, these changes might increase the prices of nonsponsored but actively promoted and well-known drugs because some people would still want those advertised on television.
Kaidi Vendla from the Estonian Pharmacies' Union said nonsponsored drugs would have to become more expensive because there is no other way for Estonian drugstores to survive financially.
The amendments would also make age requirements for pensioners the same regardless of the reason and time of their retirement in order to ensure equal access to discount drugs. In addition, changes to the law would make all drugs free to children less than four years of age.
Although all drug producers given equal treatment in Estonia, the smaller producers of generic drugs are not keen on entering the local market. One of the innovations required by the EU is a 90-day certification-deadline for every drug that has been EU certified, a change that is also foreseen in the current amendments. But Estonia plans to go beyond that, according to Kork, by expanding the three month deadline to apply to even those drugs that have not yet received certification in the European bloc but are still safe because of strict EU production rules.
"I hope we will include 90-day certification for every drug produced in the EU in accordance with the union's requirements. That will enable the import and sales of cheaper, generic drugs," said Kork.
"We have a smaller variety of generic drugs than we could have. For those producers Estonia is a fairly small market, and the current registration rules are too complicated," Kork said.
Last year Estonia spent about 600 million kroons (38 million euros) on prescription drug compensation. Presently the Estonian Health Insurance Fund compensates up to 100 percent of the medication price, and the compensation rate is marked on the prescription.
"In Estonia wholesale companies that supply drugstores raise the purchase price by an average of 7 percent, and drugstores in turn add another 16 percent. This is not what we could possibly bring down, but what we definitely do not want to go up," said Kork.
The limits set by the state for drugs vary from 15 percent to 35 percent of the wholesale price, depending on that wholesale price, but cannot exceed the maximum of 105 kroons. In Latvia and Lithuania wholesale companies raise the cost of drugs from 14 percent to 18 percent, according to Kork.