The Swedish government is planning the biggest rise in patients’ co-payments for prescription drugs in over a decade. Chronically ill and low-income patients would be hit hardest, warn opposition parties and patient groups.
In a December memorandum the centre-right government, backed by the Sweden Democrats, proposed that from 1 July next year, patients will have to pay a greater share of the rising expenditure on medicines – it would affect millions of chronically ill people and other patients.
Mikaela Odemyr, President of the Swedish Asthma and Allergy Association, and other patient organisations oppose this idea.
“It is amazing and fantastic that so many diseases are now treatable, but the government’s proposal really hits the chronically ill and poor people who are already struggling in life. There is a real risk that many people, living on the margins, will skip buying their medicines,” she said.
What comes next
Odemyr is also concerned about whether making patients pay more will be the government’s leading principle for dealing with ‘the explosion’ of new and innovative drugs in the future.
“I am a bit shocked and wonder what increases in the co-payments we will see in the future. In Sweden, there are, for example, 800,000 people with various degrees of asthma, and many of them need medicines on a daily basis.”
The new plan means that patients – as a group – will pay €235 million more for prescription medicines in 2027 than today when the new system takes full effect.
In addition to this amount, there is a tiered discount system, according to which a patient currently pays a maximum of €252 over a 12-month period until high-cost coverage kicks in.
It is now proposed that this amount be increased to €330.
After that, prescription medicines will be free of charge for the patient. Hospitalised patients do not pay for medicines, as the regions fully cover the budget.
Sort-sighted strategy
Nicklas Mårtensson, president of the Swedish Disability Rights Federation, which includes 53 patient organisations representing 400,000 individual members, also protests the plan.
“Considering that the Swedish economy has a reform scope of € 5,2 billion next year and Sweden has a very low budget deficit, it is a strange prioritisation to increase co-payments for vulnerable citizens. It is also short-sighted because if people cannot afford their medicines, they can’t go to work, their illnesses risk getting worse, and people may end up in hospital, which means higher costs for society,” he told Euractiv.
Margareta Haag, Chair of the Swedish Network Against Cancer, is also concerned: “We feel bad vibrations as patients have told us that they will not be able to buy their medicines.”
Unavoidable move to address high costs
If the plan is implemented, it will mean the first major increase in patients’ out-of-pocket costs for prescription drugs in Sweden since 2012.
Acko Ankarberg Johansson, the country’s Christian Democrat Health Minister, defended raising patient co-payment in an interview on Swedish radio earlier this autumn.
“We will do everything we can to ensure that those who need a lot of medication are affected the least, but we will probably all have to pay more for medication. I can’t see that the cost of medicines will go down as we get new innovative medicines that could help or be a cure,” she said.
As Anders W. Johansson, a paediatrician, health spokesperson, and MEP for the Center party, told Euractiv, he also supports the idea of patients paying more for prescription medicines.
Health minister in the ‘hot seat’
Meanwhile, other opposition parties, such as the Green Party, the Left Party and the Social Democrats, have expressed their discontent. The Health Minister is now being called to meet with the Swedish Parliament’s Health and Welfare Committee early next year.
“She will have to answer why the government, and the Sweden Democrats have not considered other options than passing on costs to the most vulnerable patients,” Fredrik Lund Sammeli, Social Democrat MEP and vice-president of the Committee, told Euractiv.
The Social Democrats agree with cutting costs on government spending on medicines, but as Lund Sammeli explained, this should be done through other means, such as using smarter procurement models or entering into procurement collaborations with other EU countries.
According to the Green MEP Ulrika Westerlund, a study by the Swedish Parliament’s investigative service confirms that the chronically ill, those on low incomes and the elderly will be hit the hardest.
“We do not support this plan, nor to cut spending on medicines in the national budget next year,” she told Euractiv.
Almost two in five Swedish adults (38%) reported having at least one chronic disease in 2019, which is slightly higher than in the EU as a whole (36%), according to the EU Statistics on Income and Living Conditions 2021.
[Edited by Vasiliki Angouridi, Brian Maguire]