Reason for doxycycline price increase - and what should it look like.
It's not just generic drug makers like Cephalon who are facing a potential "tax hike" by New Zealand Pharmacy.
FiercePharma's analysis of the market price doxycycline based on the wholesale price reveals increases - at least in New Zealand - have been fairly evenly spread between brand name and generic.
At least one big retailer's price increase on doxycycline of more than $100 a pop was largely attributable to the manufacturer's price hike.
There were also a number of price increases (for brand and generic) within the pharmacist's fee range.
The biggest retail price increases in New Zealand Buspar 5mg $89.42 - $0.33 Per pill were on generics (in dollar terms at least) which showed a similar picture to the wholesale price.
In total, the median retail per patient price increases ranged from a low of $5 to high $20.
FiercePharma noted that these prices could rise again because of generic pricing pressures.
Pharmacy chain pharmacies have been the source of significant price increases and have been the target of government policy reform - Price of synthroid 100 mcg first the price freeze and then rebate review. Both actions are set to go ahead in July, 2018.
But pharmacy owners remain hopeful that the new proposals will see their revenues rise. Pharmacies and customers are concerned that those proposals will mean cuts to the pharmacies' rebate and/or higher pharmaceuticals costs.
The Pharmacy Council of New Zealand (PCNZ) has long argued that the pharmacist rebate system is an unfair form of price regulation that should be scrapped, especially in light of the fact that rebate is being abolished in the majority of countries that currently use it.
The Pharmacists' Association has already come out in support of the proposal to scrap rebate and PCNZ's general manager of finance, Gary Smith, told FiercePharma that it was unlikely pharmacies would pass on the increase in pharmacy fees to their patients.
The Pharmacy Council estimates that new proposals will result in a loss of $250 million in revenue over the next two years.
While pharmacies will be paying for the cost of rebate (presumably at some point), Smith said the Pharmacy Council's financial analysis found that more than three-quarters of customers would not feel an impact on their pharmacy bills.
Smith estimated that the rebate would affect just one per cent of customers. However, that small slice of the pie could be enough to prompt a significant response from pharmacies because the Pharmacy Council's report assumes that no patients would switch to an alternative pharmacy if the rebate was removed from market.
Pharmacists had been lobbying in the community to ensure Government is responsive the concerns of New Zealand Pharmacists.
"Pharmacists are also a key part of the solution in reduction over 50% drug prices (for brand and generic) in New Zealand," Smith said.
FiercePharma's analysis shows that on average, generic costs in New Zealand are about 60 cents a vial, while brand versions like Teva, AstraZeneca, Cipla, Pfizer and Schering-Plough typically cost 50 cents.
Pharmacists' fees had not changed significantly since the last time FiercePharma analysed market on this topic in 2014 - but there were notable price increases at some of the more popular pharmacies.
Walgreens had an estimated price increase of $35 (about 7%) on their brand name versions of doxycycline and fluoroquinolones.
Other more popular pharmacies have an estimated increases of $17 - $23 on Brandis, AbbVie, Cephalon, Amgen and Actavis, respectively.
The lowest-priced drug, diclofenac, a first-line option in serious heart failure patients, cost $7.19 per vial in the average pharmacy 2016.
An average New Zealand pharmacy can expect about $30 - $60 per patient day to supply their medications. However, there are pharmacies that could be selling prescription medications for a few hundred dollars per vial.
In 2016, the average fee New Zealand pharmacies was $7.20 - and that figure includes sales of prescription medications.
New Zealand Pharmacists Association chief executive Paul Murphy told FiercePharma that some pharmacists were concerned about rising pharmacist fees from a variety of pressures including pharmakon fees, pharmacy rebates and increases to the pharmacist fee, but were hopeful that the proposals will lead to "realism".
The proposed reforms come after Government announced a number of changes to the pharmaceutical benefits scheme in 2016, a move that has prompted criticism from pharmacists.
One important part of these reforms in the pharmaceutical benefits scheme is requirement that pharmaceutical companies disclose price increases to the scheme and public.
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