OBJECTIVES: Price increases for non-generic medicines within the pharmaceutical benefits scheme are only granted in exceptional cases in Sweden. This study assessed price increase decisions for prescription drugs in Sweden and identified relevant factors linked to the decision outcomes.

METHODS: The database for reimbursement decisions from the Swedish Dental and Pharmaceutical Benefits Agency was used to identify decisions regarding price increases of prescription drugs between 1 January 2019 and 15 June 2022. The published decision documents were qualitatively assessed, identifying relevant factors for the decision outcome and the relative price increases (pharmacy selling prices) of the approved decisions were quantified.

RESULTS: During the study period, 56 medicines were subject to price increase applications, of which 39 were approved. Medicines included, amongst others, human immunoglobulin therapies, therapies for depression, schizophrenia, and anxiety as well as therapies for patients with high blood pressure. The median price increase was 46% and the largest approved increase was 565%. The relative price increase varied between treatments and indications.

Relevant factors regarding the price increase decision were the perceived severity of the condition and potential challenges linked to treatment interruption or switching including the mode of administration, intolerances to treatment alternatives, and side effect profiles. Additionally, risks associated with a diminished supply, the availability of alternative treatment options, and the initial price level in comparison to other European countries and treatment alternatives in Sweden were taken into consideration.

CONCLUSIONS: Most of the available price increase applications during the study period resulted in a price increase. While the relative price increase varied between medicines, common factors were identified including the availability of treatment alternatives and potential challenges linked to a diminished supply.