Fears that patients will have to be handpicked for drug treatment

Due to insufficient funding, Landspítali (the National University Hospital of Iceland) may be forced to choose which patients receive appropriate drug treatments and which do not, according to a recent report from the hospital's drug committee.

The report, published on the hospital's website, states that unless additional funding is allocated for drug purchases, Iceland will quickly fall behind other Nordic countries. It will also become difficult to ensure equality if new patients are unable to access treatments already in use by others.

“If a newly diagnosed cancer patient comes to Landspítali today, they may not receive the same treatment as the one who came yesterday,” said Jakob Falur Garðarsson, CEO of Frumtök, the Association of Research-Based Pharmaceutical Companies, in an interview with Morgunblaðið. “This is a deeply serious situation.”

Warnings were given ahead of budget approval

Garðarsson points out that when this year’s national budget was passed, Landspítali had already warned that the allocated funding would not suffice. In a memorandum submitted prior to the budget, the hospital stated that in order to pay for already adopted treatments and ensure access to new medications on par with neighboring countries, funding for the drug budget would need to increase by 2.078 billion ISK.

That warning was not heeded during the budget process.

New Treatments Not Being Approved – Even for New Patients

In a letter sent by the hospital's CEO to the Minister of Health in February, it was noted that the hospital's drug committee no longer considers it feasible to approve coverage for new medications, individual payment assistance, or enroll new patients in treatments that were approved last year.

A March meeting report also stated that discussions had taken place with the Ministry of Health regarding the hospital’s memorandum, but that the outcome suggested little hope of increased funding this year.

Calls for recognition of Iceland's market size

Garðarsson says Frumtök has repeatedly pointed out that the current budget is insufficient and that Iceland’s small market size is not taken into account in the country’s drug pricing model. He believes this partly explains the limited access to the newest and best medications.

He proposes that Iceland base its pricing on average prices in the Nordic countries instead of the lowest price, and that unique factors such as high distribution and administrative costs be considered.

“Such a change would be a major improvement but would still need to be supported by increased funding. The warnings from Landspítali’s drug committee clearly show that the lack of resources is already affecting patients,” Garðarsson says, urging authorities to act immediately to ensure healthcare that stands up to comparisons with Iceland’s neighbors.