Competencia limitada en la importación paralela de medicamentos: el caso de la simvastatina en Alemania, Holanda y el Reino Unido
Constrained competition in parallel drug importation: the case of simvastatin in Germany, the Netherlands, and the United Kingdom
Joan Costa-Fonta,
, Panos Kanavosb
Autor para correspondencia
j.costa-font@lse.ac.uk
Correspondencia: Joan Costa-Font. LSE Health (Cowdray House), London School of Economics. Houghton Street, London WC2A 2AE.
Correspondencia: Joan Costa-Font. LSE Health (Cowdray House), London School of Economics. Houghton Street, London WC2A 2AE.
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LSE Health (Cowdray House), London School of Economics. Houghton Street, London WC2A 2AE." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Constrained competition in parallel drug importation: the case of simvastatin in Germany, the Netherlands, and the United Kingdom" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-08-29" "fechaAceptado" => "2006-02-27" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec14002" "palabras" => array:5 [ 0 => "Importaciones paralelas" 1 => "Arbitraje" 2 => "Recuperación de descuentos" 3 => "Competencia en precio de medicamentos" 4 => "Simvastatina" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec14001" "palabras" => array:5 [ 0 => "Parallel imports" 1 => "Arbitrage" 2 => "Clawback" 3 => "Drug price competition" 4 => "Simvastatin" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Examinar los efectos de la entrada de simvastatina paralelamente importada sobre el precio de los medicamentos en los 3 principales países importadores de medicamentos en la Unión Europea: Reino Unido, Alemania y Holanda.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estimar la cuota de mercado de la simvastatina paralelamente importada, así como el precio unitario (del producto localmente producido y el importado) ajustado por dosis diaria definida (DDD) en el país de importación, y el precio unitario ajustado por DDD en el país de exportación (España). Estimaciones por mínimos cuadrados ordinarios para determinar la existencia de competencia en precios, derivada de la importación paralela de medicamentos en el período 1997-2002.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La cuota de mercado de la simvastatina paralelamente importada experimenta un aumento progresivo (sobre todo en el Reino Unido y Alemania) en el período analizado, sin que ello determine que la diferencia de precio entre la simvastatina localmente producida y la importada sea significativa. Mientras que la evolución de precios tiende al alza en el Reino Unido y Alemania, en Holanda muestra un efecto contrario. No se hallan efectos competitivos derivados de la expansión del comercio paralelo.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p class="elsevierStyleSimplePara elsevierViewall">La importación paralela de medicamentos en la Unión Europea comporta efectos inesperados (limitada competencia) sobre los precios de los medicamentos, al ser un competidor adicional en el mercado. Ello en parte es el resultado de una regulación de precios que no incentiva la competencia, y de la falta de transparencia en el reembolso de la distribución. Esto último es debido al efecto de los descuentos informales (no observables para el investigador). El caso de la simvastatina pone en duda los ahorros de recursos para el asegurador sanitario derivados del comercio. Finalmente, de los 3 países analizados, Holanda es el único que muestra una tendencia a la baja en los precios de la simvastatina. Ello puede atribuirse al sistema de recuperación de descuentos <span class="elsevierStyleItalic">(claw back)</span> informales (implícitos).</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To examine the effects of parallel simvastatin importation on drug price in three of the main parallel importing countries in the European Union, namely the United Kingdom, Germany, and the Netherlands.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">To estimate the market share of parallel imported simvastatin and the unit price –both locally produced and parallel imported– adjusted by defined daily dose in the importing country and in the exporting country (Spain). Ordinary least squares regression was used to examine the potential price competition resulting from parallel drug trade between 1997 and 2002.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The market share of parallel imported simvastatin progressively expanded (especially in the United Kingdom and Germany) in the period examined, although the price difference between parallel imported and locally sourced simvastatin was not significant. Prices tended to rise in the United Kingdom and Germany and declined in the Netherlands. We found no evidence of pro-competitive effects resulting from the expansion of parallel trade.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStyleSimplePara elsevierViewall">The development of parallel drug importation in the European Union produced unexpected effects (limited competition) on prices that differ from those expected by the introduction of a new competitor. This is partially the result of drug price regulation scant incentives to competition and of the lack of transparency in the drug reimbursement system, especially due to the effect of informal discounts (not observable to researchers). The case of simvastatin reveals that savings to the health system from parallel trade are trivial. Finally, of the three countries examined, the only country that shows a moderate downward pattern in simvastatin prices is the Netherlands. 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Información del artículo
ISSN: 02139111Idioma original: Español
DOI:10.1157/13099121
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| 2023 Mayo | 17 | 7 | 24 |
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