Pharmaceutical companies sometimes agree to sell their drugs to hospitals at a very low price. Their aim is then to benefit from the impact of hospital prescriptions on prescriptions in the community. Patients continue to take medication prescribed in hospital sometimes for months or years after being discharged.

But the prices of reimbursed drugs for outpatients are often much higher than the free and “negotiated” prices in healthcare establishments.

According to one study, the cost of drugs that are prescribed chiefly in hospital is not much higher in pharmacies than the hospital price. On the other hand, drugs prescribed mainly for outpatients cost between 5 and 20 times more in pharmacies than in hospital. In other words, the drugs sold widely in pharmacies are generally cheap in hospitals.

Another study on statins showed that as a result of atorvastatin being sold cut-price to hospitals, the number of outpatient prescriptions increased. This increase in the number of prescriptions by general practitioners resulted in additional expenditure for the health insurance system because there was no generic substitute for atorvastatin at the time, unlike other statins that are just as effective.

And so efforts to make savings in hospitals, useful as they are, sometimes result in additional expenditure on outpatients.

©Prescrire 1 September 2015

"Discounted drug prices for hospitals: result in prescriptions for expensive drugs in the community" Prescrire Int 2015; 24 (163): 223. (Pdf, subscribers only).