Centralized drug management suffers from too much bureaucracy and opacity, according to the latest study by the Institut économique Molinari
Paris, March 11th, 2011 – The study, entitled “Medical Drugs – A rather opaque Transparency Commission” describes the workings of one of the key agencies in the French health system. According to the author of the study, “the Commission is only transparent in name and has assumed powers it is not supposed to have. Meanwhile, it disregards a number of elements that are crucial to patients’ well-being.”
The opaque ways of the Transparency Commission
While in scientific journals debates take place in broad daylight and conflicting claims are discussed openly, this is hardly the case with the Transparency Commission. Instead, those involved in discussions at the Commission’s meetings are required to keep the deliberations secret.
As per its mandate, the Transparency Commission’s opinions are restricted to the therapeutic value of drugs. Yet the body admits rejecting applications in cases where the medical service is deemed insufficient “to justify resort to national solidarity” (i.e. the welfare State). In forming its opinions, the Commission has regard to financial considerations, thus encroaching on the powers of other government agencies. This can lead to trade-offs between the interests of patients and short-term financial interests.
Commission’s opinions disregard essential aspects of patients’ well-being
Since 2004, innovative criteria such as drug acceptance, ease of use, adherence to treatment or product range extension have disappeared from the Improvement of Medical Service scoring grid. Clearly, the scorecard is arbitrarily designed or modified by the Commission, to the detriment of patients and innovation. The percentage of drugs relegated to the “no improvement” category has shot up from an average 62 percent in 2003-2004 to 89 percent in 2008-09, nearly nine out of ten products surveyed.
The Commission’s expert opinions serve to justify the Government’s policy of keeping drug prices artificially low, thus delaying market availability for certain drugs in France. This applies to Parkinson’s disease, for which the standard treatment dates back to
1960 and causes considerable side effects. New treatments for the condition have received low Improvement of Medical Service marks (marks 4 and 5) from the Commission. Prices set by the administration were correspondingly too low, and the new medications were withheld from the market in France with the resulting loss of patient welfare.
The Institut économique Molinari believes there is a risk that patients’ best interest will be overshadowed by financial considerations. This risk is compounded in an environment where health insurance management is uniform. Rather than attempting an umpteenth reallocation of responsibilities among government agencies, the French Administration could draw upon successful foreign experiences such as competitive tenders between health insurers as practiced in the Netherlands. The advantage of this solution is that it fosters the development of differentiated services, catering to a broad range of consumer expectations.
Titled Medical Drugs – A rather opaque Transparency Commission, the study is available on the Institute’s website.
The Institut économique Molinari (IEM) is an independent, non-profit research and educational organization. Its mission is to promote an economic approach to the study of public policy issues by offering innovative solutions that foster prosperity for all.
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