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NMa: Prohibition by AstraZeneca on Sales to Third Parties Contravenes Competition Act

The prohibition against supplying parties outside the premises of hospitals, imposed on hospitals and pharmacies by AstraZeneca, contravenes the Competition Act. NMa made this ruling in a decision relating to the medicine manufacturer AstraZeneca.

Hospitals which purchase medicines from AstraZeneca are given very large discounts on condition that they only use these medicines for patients admitted to hospital (clinical care). The resale of these medicines, for instance to private individuals or pharmacies (out-patient care), is explicitly prohibited by AstraZeneca.

By imposing a resale prohibition, AstraZeneca artificially maintains a price difference between clinical care and the out-patient segment. This obstructs potential competition and AstraZeneca removes the incentive for hospitals to switch to competitive medicines which have the same effect. Without the resale prohibition, hospitals might choose different medicines and the total costs may be lower than they are at present.

The legislator’s aim is to enable hospitals to compete with pharmacies by giving hospitals the possibility of also supplying patients who have not been hospitalised with medicines, through polyclinic pharmacies in or near the hospital. This gives consumers greater freedom of choice in obtaining medicines. In addition, pharmacies have been encouraged to improve their efficiency and quality, and this may give rise to an incentive to supply medicines at prices below the present maximum prices. AstraZeneca’s resale prohibition is an obstacle to realising the effects intended by the legislator.

It is important for pharmaceutical companies to acquire a large interest in the clinical care segment. General practitioners generally prescribe the same medicine for hospital patients as the hospital’s specialist (the so-called influential effect). AstraZeneca’s high discounts make it difficult for producers to acquire a position in clinical care, as hospitals will not be quick to switch to a competitive medicine because of these high discounts.