Vad får framtidens läkemedel kosta och vad kan de ge i besparingar?

The pharmaceutical market is undergoing major changes, and the development of orphan drugs, gene and cell therapies and precision medicine leads to new challenges. For many years, the United States and Europe have been fighting for first place as to who develops the newest chemical and biological innovative drug substances. Since 2010, that picture has changed. The USA has taken over first place and Europe has stagnated. Since 2019, China has entered as an important innovator and in recent years even passed Europe. One of the conclusions in the report is that pharmaceuticals (9% of health care expenditure) are an input factor in health care that has the potential to affect both the total health care expenditure (where, for example, functional impairments are included with 26%) as well as the total costs of illness. We should look beyond existing budgets and responsibilities. The report contains three proposals for renewal and development. The first proposal is that the value-based pricing (VBP) should be renewed and adapted to the new pharmaceutical market. This contains both drugs for the treatment of broad public diseases and drugs for small disease populations and precision medicine. The second proposal is that we should develop and use so-called Value Based Contracts (VBC). Value-based contracts aim to reduce uncertainty around valuation and payment. VBC is a way to speed up access to new innovative treatments even if the uncertainty surrounding the value is significant. The third proposal is related to the development of VBC and means that we should improve the negotiation process for pharmaceutical agreements.