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Published on 15 September 2009

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The advent of the Swedish EU Presidency


Sweden opens up its pharmaceutical markets
as it takes over the Presidency of the EU

Brian Edwards

Emeritus Professor of
Healthcare Development
University of Sheffield

Former President
HOPE (European
Hospital and Healthcare
Brussels, Belgium

The Swedish Government took over the Presidency of the EU on 1 July 2009. They are focused on bringing the community out of the current economic crisis and will give priority to measures that reduce unemployment and bring citizens back into the labour market. They will be looking to lay the foundations for a new long-term strategy for growth and jobs. Sweden’s EU health agenda covers health and ageing, antibiotics resistance, alcohol, communicable diseases and e-health. The discussions about antibiotic resistance are particularly interesting as the Swedes want the discussion to examine how the EU can stimulate the development of new and effective pharmaceuticals before resistance levels place us in a similar situation to that predating the discovery of antibiotics.

The influenza pandemic, which at one point looked set to engulf the EU agenda, now looks to be under control due mainly to its relatively mild consequences. The European Centre for Disease Prevention and Control (ECDC) did, however, issue guidance in June 2009 on the kind of public health measures that could be deployed to reduce the number of people infected and minimise both morbidity and mortality. Early action can delay the peak of the epidemic curve until nearer the time when a vaccine becomes available. It may also minimise the secondary consequences caused when many people fall sick at the same time causing mass absenteeism in vital services.

On the national front, Sweden’s new centre-right government has an ambitious programme of change for its own health system, which is funded and provided by county and regional councils. The government wants them to stimulate new private enterprises and health entrepreneurs in order to improve access for patients. They want all citizens to be able to choose a public or a private health centre at which they access primary care. The national government will also put in place incentives to encourage local health authorities to reduce waiting times. One billion Swedish kroner will be allocated in 2010 to those councils that managed to shorten their waiting lists in the previous year. Another billion will be allocated to those councils who reduce the level of sick leave amongst their populations.

On the pharmaceutical front, major change is underway as the Government seeks to open up its pharmaceutical market to greater competition. The state-owned Apoteket, which has had an exclusive right to sell medicines for more than 35 years, including both prescription and nonprescription drugs, has lost its monopoly powers. These powers were relaxed a little in 2008 allowing nicotine replacement drugs to be sold elsewhere other than a pharmacy, and this is now being extended to a wider range of products.

From 1 July 2009 companies that secure authorisation from the Medical Products Agency will be able to retail pharmaceutical products that previously were only available from Apoteket. The Government’s intention is to make Apoteket one retailer amongst many, and in order to speed up the process they will be required to sell two-thirds of their pharmaceutical outlets to private sector operators. It is expected that competition will have a downward impact on prices. As Social Minister Goran Hagglund put it:’Medical products sold in Sweden are sold with quite a narrow margin, but that margin can be tightened by having more actors compete.’ 1 It is reported that German companies plan a major expansion into this new market, and many people who work in Apoteket are also planning to start up independent pharmacies.


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