The expenses for hospital pharmaceuticals in Denmark has increased more than 80% the last decade. The increased expenditure is particularity caused by new and expensive patent-protected medicine. Amgros carries out EU-tender calls for 98% of hospital medicine used at public hospitals in Denmark. The opportunity to achieve price discounts on patent-protected pharmaceuticals through tender calls are minimal due to the limited competition. In order to accommodate this, a unique analogue competition model was developed by Amgros and the Danish Regions. The purpose of this study was to explore the effects of the analogue competition model on pharmaceutical prices in the therapeutic area hepatitis C in the period from 2014-2018. The study was designed as a case study including semi-structured interviews with relevant stakeholders in the industry, Danish Regions, and Amgros. Quantitative data including both list prices and actual purchase prices were withdrawn with special permission from Amgros´ database. The qualitative and quantitative analysis showed that the price for one hepatitis C treatment decreased 77% (from 531.406 DKK to 121.798 DKK per patient) for genotype 1 and 32% (from 531.406 DKK to 363.780 DKK per patient) for genotype 3 within the period 2014-2018. Important factors leading to the price decreases were the following: the therapeutic treatment guidelines produced by the Danish Medicines Council equalling the medicine at ATC level 5, the number of pharmaceuticals for each disease genotype on the market at each tender, the incentive structure created by the Amgros tender system with possibilities of being ranked as first choice with an 75% market share, and the size of the patient population. The analysis showed that the analogue model was effective in creating an oligopoly competition market situation within the therapeutic area hepatitis C.
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