30 June 2014

29 June 2014: Τhe prices of some generic drugs in Greece and Sweden. A comparison.

My blog is almost always in Greek. This time though, I will write in English because I want my audience to be international. Well, if you wonder why Greece is bankrupt, I think that here you are going to read an important part of the answer:          


A short presentation of myself first: My name is Argirios Argiriou. I have studied Medicine in Lund, Sweden and I specialized in General Practice in Linkoping Sweden. Since 2005 I work as a private General Practitioner in my hometown Kavala, Greece. I still work though, as a locum doctor in Sweden for some weeks every year, and that helps me to keep in touch with both the Greek and the Swedish clinical reality.

The last time I worked as a locum in Sweden was in Amal ( www.amal.se ) which is a municipality with 9000 inhabitants and only one pharmacy while me birthplace in Greece, Hrisoupolis, (http://el.wikipedia.org/wiki/%CE%A7%CF%81%CF%85%CF%83%CE%BF%CF%8D%CF%80%CE%BF%CE%BB%CE%B7_%CE%9A%CE%B1%CE%B2%CE%AC%CE%BB%CE%B1%CF%82 ) with about the same population as Amal, has 10 pharmacies.


On June the 29th, 2014 I did a price comparison between seven different generics in Greece and Sweden.

I got the prices ( Retail Prices ) of the Swedish generics from the online National Formulary of Sweden
www.fass.se ( You can see them, all the way down on the pages that open from the following Swedish links. Wherever you see the symbol - means integer in Swedish kronor. For example 52 - means 52 kronor . Unlike the : means that it will follow a decimal number eg 54:50 means 54.5 kronor ) .

I got the prices (also Retail Prices ) of the Greek generics from the site 
www.galinos.gr which is a private but well updated site that a lot of Greek Doctors use in order to find out the prices of the medicines that they prescribe.

On 29 June 2014, 100 Swedish Crones (SEK) = 10,88 Euro .

For medicines for chronic diseases, such as the following medicines, the packaging is usually 28 or 30 tablets/box in Greece, while in Sweden the packaging is usually of 98 or 100 tablets/box.

Since a similar comparison that I did in September 2013 the Greek medicines are a little bit cheaper but still much more expensive than the Swedish ones:

Omeprazole.

In Sweden the Caps. Omeprazole Teva 20 mg x 98 (i.e. a box with 98 capsules of Omeprazole Teva 20 mg), costs 59 SEK = 6,4  Euro

            when

In Greece the Caps. Penrazol 20 mg x 28 costs 13 Euro


Ie the generic Omeprazole is 
610 % more expensive in Greece than in Sweden.

Simvastatin.

In Sweden Tabl. Simvastatin Krka 40 mg x 100 costing 69.5 SEK = 7,56 Euro

http://www.fass.se/LIF/product?userType=0&nplId=20041018000310

when

In Greece the Tabl. Extrastatin 40 mg x 30 costs 18,05 euros

Ie the generic Simvastatin is 
695 % more expensive in Greece than in Sweden.


Atorvastatin

In Sweden Tabl. Atorvastatin Bluefish 20 mg x 100 costs 58 SEK = 6,31 Euro

http://www.fass.se/LIF/product?userType=0&nplId=20091210000151

                                                                                                                                                                   when

In Greece the Tabl. Atorstat 20 mg x 30 costs 14,90 Euro
http://www.galinos.gr/web/drugs/main/packages/10934#content


Ie the generic Atorvastatin is 
687 % more expensive in Greece than in Sweden.

Finasteride

In Sweden Tabl. Finasterid Teva 5 mg x 100 costs 92 SEK = 10,00 Euro

when

In Greece the Tabl. Finastir 5 mg x 30 costs 12 euros
http://www.galinos.gr/web/drugs/main/packages/12185#content

Ie generic Finasteride is 
300 % more expensive in Greece than in Sweden

Risperidone

In Sweden Tabl. Risperidon Teva 1 mg x 60 costs 59 SEK = 6,41 Euro


when

In Greece the Tabl. Rispelen 1 mg x 20 costs 7,01 Euro

Ie generic Risperidone is 
228 % more expensive in Greece than in Sweden.

Olanzapine

In Sweden Tabl. Olanzapine Teva 10 mg x 56 costing 61,50 SEK = 6,69 Euro.


when

In Greece the Tabl.Villamos 10 mg x 28 cost 41,05 Euros.
http://www.galinos.gr/web/drugs/main/packages/19008#content


Ie generic Olanzapine is 
1127 % more expensive in Greece than in Sweden.

Citalopram

In Sweden Tabl. Citalopram Sandoz 20 mg x 100 costing 57 SEK = 6,2 Euro.

when

In Greece the Tabl. Seror 20 mg x 28 cost 9,92 Euros.
http://www.galinos.gr/web/drugs/main/packages/15120#content

Ie generic Citalopram is 
471 % more expensive in Greece than in Sweden.

Even generics that are produced in Greece, can be found with a reduced price in Sweden: For example, a generic named "Rolenium 50/500" (produced in Greece by ELPEN http://www.elpen.gr) that costs 48.3€ in Greece, is imported to Sweden by "Bluefish Pharma" under the name Relanio and has price: 46.2€ (424.5 SEK). In this image: http://www.relanio.se/wp-content/uploads/2013/03/Forpackning-framifran.png  at the left down side you can see the ELPEN's brandname.
http://www.fass.se/LIF/product?userType=0&nplId=20100423000091

Does the Greek Government really want to reduce the cost of pharmaceutical expenditure in Greece ?

Then why don’t they reduce the price of generic drugs at Swedish levels?


Postscript : The fact that the prices of generics are held so high, flares on the over-prescribing of medicines by some corrupt doctors. (The larger the super-profits the  larger the kickbacks to the Doctors ..)

 


Dr Argirios Argiriou
Specialist in General Practice.
www.argiriou.se



14 June 2014

Health depends mostly on exogenous factors not the healthcare system.

Richard Smith: The case for slow medicine

17 Dec, 12 | by BMJ

The characteristics of health systems are complexity, uncertainty, opacity, poor measurement, variability in decision making, asymmetry of information, conflict of interest, and corruption. They are thus largely a black box and uncontrollable, said Gianfranco Domenighetti of the Università della Svizzera Italiana at a meeting in Bologna on La Sanità tra Ragione e passione (Health through reason and passion). The meeting was held to celebrate the life and work of Alessandro Liberati, the founder of the Italian Cochrane Centre, who died last year.
Only 11% of 3000 health interventions have good evidence to support them, said Domenighetti. A third of the activity in the US health system produces no benefit, said a recent study in the New England Journal of Medicine. Half of all angioplasties are unnecessary. Some €153m a day is lost through corruption in health systems in the European Union. Four fifths of new drugs are copies of old drugs. Screening is creating diseases like ductal carcinoma in situ. Most doctors (80-90%) have taken “bribes” from pharmaceutical companies, although many may not see their free pens and lunches and subsidised travel as bribes (but if they are not bribes what are they?). Between 15% and 40% of articles in medical journals are ghostwritten. Half of clinical trials are not published, and there is systematic bias towards positive results, hence suggesting that treatments, usually drugs, are more effective and safer than they actually are.
Yet against this backcloth more than four fifths of people in most countries think medicine is an “exact or almost exact science.” In a study published in the Annals of Internal Medicine nearly 90% of patients undergoing percutaneous coronary intervention (PCI) thought that it would reduce their chances of having a heart attack, when it doesn’t. Asked about various scenarios almost half of cardiologists questioned would go ahead with a PCI even when they believed there was no benefit to the patient.
It is time, said Domenighetti, to open up the black box of healthcare. Encouraging “health literacy” seems to be a way to do this, but Domenighetti thought that this was “old wine in new bottles.” We need, he said, to encourage a healthy skepticism about the medical market and to help people understand that medicine is far from being an exact science. Data should be published exposing variations in practice, corruption, and conflicts of interest. We should explain that health depends mostly on exogenous factors not the healthcare system. And people should be given practical tools to promote their autonomy—tools like access to evidence based information.
Domenghetti ended his talk by pointing people towards the Choosing Wisely campaign in the US where professional organisations are identifying interventions that offer little or no value. A similar but broader campaign of Slow Medicine is underway in Italy, and I have little doubt that slow medicine—like slow food and slow lovemaking—is the best kind of medicine for the 21st century.
We need to pull back from what Ivan Illich called the hubris of medicine.
Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.
Competing interest: RS spoke at the meeting and had his expenses paid by the health department of Emilia-Romagna.

http://blogs.bmj.com/bmj/2012/12/17/richard-smith-the-case-for-slow-medicine/