Klekovski: From August 1, “Foster” will be available with no extra charge

The director of the Health Insurance Fund, Sasho Klekovski, announced today at a press conference that the medicine “Foster,” used as inhalation therapy for asthma and chronic obstructive pulmonary disease (COPD), is expected to be available in pharmacies from August 1 without an extra charge, while the co-payment will be 280 denars. He also announced that for the anticoagulant “Xarelto” (rivaroxaban), starting from January 1, only a co-payment of 160 denars will be required.

Klekovski explained that there are two ways to help reduce drug prices. According to him, the first is to include the medicine on the positive list, where a lower price can be secured through negotiations, since this list also provides access to state subsidies. The second is the entry of generic competition, an approach recommended by the World Health Organization.

He said that when only one brand appears on the positive list, the pharmaceutical company has very little reason to lower the price. By contrast, he added, the arrival of competition forces such a reduction, because a generic must enter the market at a lower price.

Speaking about specific examples, Klekovski first mentioned rivaroxaban (“Xarelto”), which cost 2,200 denars and was more expensive than in neighboring countries, which is why many citizens bought it abroad. With its inclusion on the positive list, he said, by the end of the year the price will be cut in half and will be cheaper than in Kosovo. From January 1, the co-payment for this medicine will be only 160 denars.

As a second case, he mentioned “Foster,” the inhalation therapy for asthma and COPD, which until now had been the only original medicine on the market. After its patent protection expired, the generic “Bloceta,” produced in the EU, appeared on the market, and its entry onto the positive list was made at a significantly lower price. As a result, the reference price in this category of medicines fell from 2,715 denars including VAT to 1,915 denars, a drop of 800 denars.

He stressed that this reduction made it possible for “Bloceta” to be offered to patients without an extra charge, while at the same time creating pressure on the manufacturer of the original medicine “Foster” (formoterol/beclometasone) to lower its price as well.

According to Klekovski, after three weeks of communication, the manufacturer of “Foster” informed them yesterday that it accepts selling this medicine in pharmacies in Macedonia at the new reference price of 1,915 denars. This means the medicine will be available without an extra charge and only with a co-payment of 280 denars, or 20 denars less than before. He clarified that the new price will take effect once the current quantities already supplied to pharmacies are sold. “I expect that from August 1, ‘Foster’ will be without an extra charge. ‘Bloceta’ is already available without an extra charge,” Klekovski said.

He added that the around 50 million denars saved from the 800-denar reduction in the reference price of “Foster” will not be used to buy vehicles, but by the end of the year will be used to introduce a newer-generation medicine for patients with asthma and COPD.

In conclusion, Klekovski assessed that price changes in such categories of medicines often meet resistance, because halving the price also means halving the profits of pharmaceutical companies, as well as retail sales margins.