Research from four European cancer care institutes, led by the Amsterdam Antonie van Leeuwenhoek (AvL) hospital, shows that drug prices differ greatly within Europe. The study will be published later today in the journal Lancet Oncology.

Study design

For the study 21 cancer centers in 15 countries supplied the cost prices they pay for nine drugs. These included not only the official prices asked by the pharmaceutical companies, but also the real costs hospitals paid after any negotiated discounts. For 7 out of 9 drugs, the Netherlands were in the top-3 of countries who paid most for a specific drug. The mean drug price for cancer is eight percent higher than the European average.

Author’s response

Researcher Wim van Harten’s (AvL) states that the reasons for the differences in price aren’t explained by this study. It does show though, that the price differences cannot be attributed to the gross national product per capita or national product purchasing arrangements. The researchers stress the importance of a transparent drug pricing policy. Furthermore, the study shows there is room for negotiation, which would help to cut costs.

Example: Trastuzumab

An example of a drug for which the price diverges greatly is Trastuzumab, a monoclonal antibody used in the treatment of HER2-positive metastatic breast cancer. In the Netherlands, the AvL pays over €605 per 150 mg of the drug, about a euro less than the official asking price in the Netherlands. The participating Italian cancer centre pays almost €558, after a negotiated discount of €350 on the official Italian asking price of €913. (source)

Centralized vs. decentralized procurement

There are large differences in approach to the purchasing of drugs and price agreements between countries in the study. In Norway the government negotiates with the pharmaceutical companies about the drug prices, in Germany a powerful association of hospitals conducts the negotiations, while in the Netherlands each hospital negotiates its own price. Both Norway and Germany pay lower prices for most of the drugs in the study.

Take-home message

This study brings new material for the debate about the way drug prices are negotiated. Perhaps the different governments and hospitals throughout Europe will see this as an incentive to work more closely together for fairer drug prices and equity in Europe.