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Why some hospitals themselves make drugs

The costs of drugs are sometimes so high that they become too expensive to compensate. Decided two Dutch hospitals, all to itself, a drug. Why is this necessary and will this in the coming years, more often going to happen?

The Amsterdam University Medical Centre (Amsterdam university medical centre (UMC) announced in april last year to take a drug against a rare genetic disease to create, for example, wrote the NRC. In the Netherlands there are over fifty treated patients on these medications.

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AMC bypasses expensive drug to the pharmacist in charge by itself means to produce

Where the drug by the manufacturer per patient 200.000 euro per year costs, the hospital can make this tool yourself for 25,000 euro. The price is so high because the provider has a monopoly on this drug and therefore as the sole provider, the price can greatly increase.

The health care provider wanted to this amount is not more compensate because of the price. For the patients this has major consequences: they get no drug or are responsible to pay for it.

“But that will be tons of costs,” explains a spokesperson of the hospital. Therefore, we have decided Amsterdam UMC-pharmacist Marleen Kemper together with professor of metabolic disease Carla Hollak to find a solution.

Patients have hardly noticed anything

The drug should of the law, if it comes to the so-called magistral “cooking on a small scale”. So it may not be for a large group of people to be made. Therefore started the Kemper and Hollak, the search for the necessary resources and was the process used to produce the drug.

The patients have hardly noticed anything of this change, but are informed about the changed situation, said the spokesman. After concerns about the availability of their medication, were they also relieved.

Also the Amsterdam hospital, Antoni van Leeuwenhoek decided last year to an extremely expensive cancer itself. The Hague pharmacist Paul Lebbink is busy with the preparation of a drug against cystic fibrosis.

Medications are far too expensive

Medicines should be accessible and affordable and that is under constant pressure, responds Wouter van der Horst, spokesman of the Dutch Association for Hospitals (NVZ). “It is good that this is happening, because all the small bits help. Medications are far too expensive and the costs are escalating.” Van der Horst has heard nothing about plans of other hospitals, which may also medicate themselves want to go.

“Drugs are expensive and costs are skyrocketing”
Wouter van der Horst, spokesman of the Dutch Association for Hospitals

New figures from the NZA shows that the expenditure on expensive medicines in 2017, and has grown to 2.08 billion euros, in 2016, it was 1.91 billion euros. According to the healthcare authority succeed, hospitals and health insurers are getting better and better in order to lower prices for medicines, but a growing number of patients.

Also, the advent of new medications for a growth of the total expenditure. Of the 23 most expensive medicines, the average expenditure per patient is more than 80,000 euros per year.

Minister Bruins speaks of ‘ridiculous prices’

The pharmaceutical companies have a dominant position in the market. Health insurers and hospitals to buy the drugs for them and are also dependent on that supply. Minister for Medical Care Bruno Bruins (VVD) warned that the pharmaceutical companies last year, after the news about the Amsterdam UMC became known.

Bruins said that he is “the rules of the game will adapt” if they have their “absurd prices” not to bring down.

The Association Innovative Medicines (VIG) takes a “strong distance” of the trend of hospitals and pharmacists to provide more space for the magistral preparation of medicines, as it is to read it on their website. According to the VIG “are there other ways to put together a better affordability of drugs to achieve”.

A lot of profit, but also cheap tools

Yet there is also another side of the coin, emphasises Van der Horst of the NVZ. “Yes, the pharmaceutical companies books huge turnovers and profits, there is a huge amount of money in the sector. But there are also medications that they make for small groups and where they have no money to earn. And what to think of tools such as puffers for people with asthma or antiallergiemiddelen? There earn no one anything.”

“We do not want the place of the pharmacist to take, but grab on if it is not otherwise”
Spokesperson AMC

The Amsterdam UNIVERSITY medical centre and the AMC Foundation to get the next five years, each year 1 million euro from the Vriendenloterij (friends lottery), in order to ensure that medications remain accessible. “We want to use this money for a platform to start”, says the spokesperson of the AMC.

There will be only other medications are made for necessity, explains the spokesman. “We do not want the place of the pharmacist to take, but it can intervene if it can’t be helped.” This will be done in cooperation with insurers, the ministry, the Inspection, and also with the company itself. “We want to help patients, and this is a last step.”

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