Facts and Figures 2016 pharmasuisse

Transcription

1 Facts and Figures 2016 pharmasuisse

2 The role of pharmacists illustrated by a sample of 1,000 people 250 people are healthy Initial contact (selfcare) Prevention (e.g. vaccination, colorectal cancer screening) 750 people have a health problem within three months Initial contact Consultation and treatment (minor ailments and health problems) Triage (possible referral to physician or emergency ward) 250 people see a physician directly Patient compliance Patient safety 50 people could also receive treatment in a pharmacy Source: White KL, Williams TF, Greenberg BG. The ecology of medical care. N Engl J Med. 1961;265:

3 The pharmacies service range Initial consultation Prevention checks Provision of medicines Vaccination Consultation medicines Patient compliance Aids Medicine chest Pharmaceutical care in nursing homes Production of medicines Checking Smoking cessation The pharmacy: Easily accessible services Customer-friendly opening hours No appointment necessary Friendly and personal service Central locations

4 Healthcare turnover by service providers 5.7 % Pharmacies incl. cost of goods of 64.3 % ( 4.0 bn) 8.5 % Others ( 6.0 bn) 17.3 % Social-medical institutions ( 12.3 bn) 36.4 % Hospitals ( 25.9 bn) Total 71.2 bn 32.1 % Outpatient provider ( 22.9 bn) Source: Swiss Federal Statistical Office, healthcare costs according to service providers 2014

5 Compulsory health insurance (CHI): gross benefits according to cost categories 25 % 20 % 15 % 10 % 5 % 0 % 23.3 % 7.0 bn 23.2 % 6.6 bn Physician outpatient 22.8 % 6.9 bn Hospital inpatient 23.3 % 6.7 bn 16.7 % 5.0 bn 17.5 % 5.0 bn Hospital outpatient 11.5 % 3.5 bn 11.4 % 3.3 bn Medicines pharmacy 6.2 % 1.9 bn 6.2 % 1.8 bn Medicines physician 19.5 % 5.9 bn Others 18.5 % 5.3 bn thereof LOA * 256 m thereof LOA * 257 m Distribution share ** 908 m Distribution share ** 889 m 2015: Total 30.1 bn 2014: Total 28.6 bn * LOA: service-based remuneration, tariff agreement between health insurers and pharmacies. ** Source: IMS Health Switzerland, estimation by pharmasuisse Source: Federal Office of Public Health; Compulsory health insurance (CHI) 2015 (STAT KV 15) and 2014 (STAT KV 14)

6 Pharmacies and physicians, dispensation of medicines and CHI benefits according to canton VD JU NE FR BS SO BL BE AG LU OW SH ZH NW ZG , UR SZ TG SG GL AR AI GR Dispensation at pharmacies (Rx) Mixed form (MF) Self-dispensation (SD) GE VS TI Source: Swiss Federal Statistical Office, monitoring of cost development in health insurance, Federal Office of Public Health, pharmasuisse General practitioners (general practitioners as well as 5,953 5,945 physicians in the outpatient sector) Pharmacies 1,774 1,764 Gross benefits of compulsory health insurance (CHI) per insured person 2015 (in )

7 Price index medicines and healthcare services Hospital services Outpatient services Physician services Healthcare Medicines Basis 2000 = 100 Source: Swiss Federal Statistical Office, Swiss consumer price index, conversion basis 2000 pharmasuisse

8 Cost development of Medicines subject to LOA Sales volume in packages Invoiced amount Earnings from dispensation of medicines A, B of specialities list (SL) Earnings Federal Office of Public Health price system net Indicators for dispensation of prescription medicines at the expense of compulsory health insurance (CHI) by pharmacies, basis 2005 = 100 * LOA = service-based remuneration, tariff agreement between health insurers and pharmacies. Source: Medicpool, calculations pharmasuisse

9 Operating revenue allocation according to financial key figures 8.2 % Other operating costs 7.0 % EBITDA 20.4 % Personnel costs Operating revenue allocation minus cost of goods 7.0 % Others 5.5 % Office and administrative expenses 10.6 % Rental expense 57.3 % Personnel costs 19.6 % EBITDA 64.3 % Cost of goods Source: Survey of rolling costs in pharmacies (RoKa) 2015 (fiscal year 2014)

10 Range of cost reductions by pharmacists Increasing patient compliance Officially mandated price reductions Relieving general practitioners Pharmaceutical care in nursing homes LOA tariff agreement Relieving hospital emergency wards Substitution with generics Quality circles

11 20,145 employees in pharmacies (medical- and health professions) 1.9 % Pharmacy business assistants (388) 5.2 % Other sales personnel (1,041) 8.9 % Other employees including chemists (1,799) 14.4 % Trainees (2,893) 41.9 % Pharmacy assistants (8,450) Health professions Medical professions (academic) 16.8 % Employed pharmacists (3,387) 9.5 % Managing pharmacists (1,905) 1.4 % Pharmacists in their studies (282) Source: Survey of rolling costs in pharmacies (RoKa) 2015 (fiscal year 2014)

12 Greatest challenge of the chronically-ill: patient compliance 4 costs Patients recognise necessity of treatment Take medicines when symptoms are acute Take medicines Patients have reservations about medicines Conviction Patients are convinced of the effects of medicines 4 costs 4 costs Do not take medicines Patients trivialise necessity of treatment Take medicines when they feel like it

13 Patient compliance reduces costs 6.5 million 20 % costs 1.2 million compliant chronically-ill patients 1 costs 2.2 million chronically-ill patients 80 % costs 1 million non-compliant chronically ill patients 4 costs Population in Switzerland Compulsory health insurance (CHI) Patient compliance Cost comparison Source: Swiss Health Observatory Obsan, Federal Office of Public Health

14 Medication costs with and without quality circles Control group without quality circle Quality circle pharmacists-physicians (example Fribourg-Pionniers) Basis 1999 = 100 Source: Prescription data OFAC 2016

15 Trends of medication costs in nursing homes with and without pharmaceutical care Nursing homes without pharmaceutical care Nursing homes with pharmaceutical care Solid line: average value from analyses compared to nursing homes without pharmaceutical care, reference year 2009 Dashed line: trends Source: Helsana, report Pharmaceutical Care in Nursing Homes of 16/06/2016

16 Price composition of medicines subject to prescription and covered by health insurance Competence Turnover Beneficiaries Health insurers and pharmacies Federal Office of Public Health Federal Office of Public Health and pharmaceutical industry 8.5 % LOA 18.2 % fixed margin 7.3 % %-margin 66.0 % ex-factory price of manufacturer Pharmacy Tariff agreement on service-based remuneration Wholesalers and pharmacies Personnel, infrastructure Capital costs, warehousing and outstanding receivables Transport, wholesale Pharmaceutical industry Research and development Marketing and approval Profit margin Distribution share Retail price of medicines Total costs Source: pharmasuisse

17 Cost allocation for medicines of varying prices , Novalgin (Price category 1) Amoxicillin Spirig HC (Price category 1) Candesartan Sandoz (Price category 2) Keppra (Price category 3) Abilify (Price category 4) Rebif (Price category 5) Revlimid 7, (Price category 6) 0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 % 80 % 90 % 100 % Ex-factory price () Surcharge per package () Price-related surcharge () Source: pharmasuisse

18 Development of sales volume per price category Price category Price category 5 Price category 1 Price category 3 Price category 2 Price category Basis 2007 = 100 Source: IMS Health, calculations pharmasuisse

19 Pharmacy density compared with other European countries per 100,000 inhabitants 28 Portugal 39 Ireland 47 Spain 22 The UK 33 France 44 Belgium Denmark 12 6 The Netherlands 22 Switzerland 25 Germany 16 Austria* 30 Italy 14 Sweden 30 Poland 36 Slovakia 38 Estonia 40 Romania 51 Bulgaria 31 = European average * state allocation Source: ABDA Deutschland, Malta 87 Greece 55 Cyprus