OBJECTIVES

: Parallel import (PI) was introduced in the pharmaceutical legislation in the Republic of Macedonia as a measure for reducing the prices of medicines and savings of the budget, primarily in the public procurement of drugs in public health institutions. We evaluate the economic impact of PI on the Macedonian health care system for period of 2015-2017.

METHODS

: Assessment was made using public data from hospital pharmacies, Ministry of Health (MH) and MALMED (Agency of medicines and medical devices) and wholesale distributors for 26 hospital medicines that were subject to PI in last three years. The annual consumption of each medicine was calculated, both from PI and regular importers (RI). Comparative analysis was made to determine: the costs of public health institutions; the difference between the offered tender prices of PI and RI medicines, and the price approved by MH. The total budget of the hospital drugs was calculated before and after the implementation of PI, taking into account the approved wholesale price and the quantity per year for each of the medicines procured. A SWOT analysis was made for determination of advantages and disadvantages of PI.

RESULTS

: The total budget for the medicinal products, imported before the introduction of PI was €30,584,240.17. Total consumption from the PI and RI public calls offers was €17,139,406.13 and €23,832,575.64, respectively. The PI, compared to RI (not receiving public procurements) obtained savings of €6,693,169.51 which were much larger (€13,444,834.03) compared to amount spent if we do not implemented PI. A trend of decrease (ranging from 18% to 40% and 61%) in wholesale prices (for both PI and RI) on public procurement was observed.

CONCLUSIONS

: PI should be considered as a measure for attaining cost savings which needs further enhancement regarding risks associated with quality of procured medicines and rational allocation of the financial resources.