Austerity in Europe Puts Pressure

on Drug Companies

by STEPHANIE NOVAK

Profits at pharmaceutical companies have been declining or showing little growth for the last year

as austerity measures across Europe lead to cuts in health care spending.

Some analysts say this trend could continue until at least 2014.

Budget cuts mean that many European governments are not willing to pay as much for pills. But new laws in some countries are also putting pressure on companies to prove their drugs are effective or risk having them dropped from the coverage list, or covered at a lower rate.

And price reductions in Europe can have a ripple effect. Profits from sales in emerging markets may also fall, because governments in emerging markets refer to the prices set in Europe to determine their own.

That would particularly hurt European pharmaceutical companies, which have been quite successful in emerging markets in the last five years. American companies, by contrast, do not rely as much on overseas revenue because of their large domestic market.

Before the recent wave of austerity measures, drug companies faced relatively low resistance from European governments when they set prices and introduced products. Countries with strong industrial bases, like Germany, France and Britain, allowed companies the most flexibility in setting prices.

“The euro crisis is forcing governments to restructure how they think about medications,” said Richard Bergström, director general of the European Federation of Pharmaceutical Industries and Associations.

Because the prices governments are willing to pay are falling, drug companies are recalibrating their strategies and considering economic factors earlier in the process of developing medicines. They are also reducing the number of new drugs in which they invest research money.

On average, West European countries spend 8 to 12 percent of their gross domestic product on health care — a proportion that has remained stable despite the crisis, according to the Organization for Economic Cooperation and Development.

The pharmaceutical sector, though, is being hit disproportionately hard because cutting prices for pills is a quick way to reduce spending, compared with alternatives like cutting money for hospitals or restructuring health care systems.

In the last year, pharmaceutical sales to pharmacies and hospitals declined 2.2 percent in France, 3.1 percent in Italy and nearly 9 percent in Spain, according to Business Monitor International, a company in London that follows the pharmaceutical industry.

Analysts say that it is difficult to predict how badly profits will be affected in the next fiscal year. Other factors, including expiring patents, mean that each company’s profit will be affected differently.

Still, “the austerity measures themselves are going to affect everyone,” Mr. Bergström said.

And the numbers are not encouraging.

Novartis, the Swiss pharmaceutical giant, posted a 7 percent decline in net income for 2011 despite a 16 percent increase in sales. AstraZeneca, based in Britain, posted full-year revenue for 2011 of $1.34 billion, down 2 percent from 2010. In 2011, net profit for the company’s West European market was down 11 percent from the previous year.

Kaushal Shah, an analyst with Business Monitor International, said the clearest way to see the effects of the euro crisis on pharmaceutical companies was in job cuts. AstraZeneca plans to cut more than 7,000 jobs in Europe, in addition to the 21,600 positions it has eliminated since 2007. Novartis, a largely European company, will cut nearly 2,000 jobs in the United States this year. Pfizer cut 6,000 jobs last May. In times of hardship, pharmaceutical companies usually lay off sales representatives and protect research and development departments, which lead drug creation. In this crisis, even research and development positions face cuts as companies strive to make these departments more efficient so as to reduce costs while maintaining a pipeline of new products.

“2011 is the first year recorded where R.& D. is down in the industry as a whole,” Mr. Bergström said. As euro zone countries lower the prices they pay for pills, the European market will also feel the effects of cross-referencing by governments, looking to pill prices in other countries to help determine what they will pay.

Portugal, which cross-references by taking an average of the five cheapest prices of a drug in other countries, is one of many nations that do this. Italy, Germany and Spain are among other countries that cross-reference.

Adding to the challenge for companies is the need to show newly cost-conscious governments that their drugs are cost effective.

Germany, Europe’s largest pharmaceutical market, has required drug companies since January 2011 to prove the added benefit of a new medication by producing documentation comparing it with other treatments on the market.

The German government will now pay higher prices only for drugs that clearly demonstrate a unique benefit in relation to other medicines and therapies already available, making Germany the first country in the euro zone to enact such measures as a major part of changes to health care policy. Partly as a result of these changes, the German government reported saving 1.9 billion euros on drugs in 2011, three times the savings in 2010, Business Monitor International said.

Drug companies worry that actions in Germany could hurt sales in other European markets.

“What the industry is seeing now is that process is not so automatic; payers are not always willing to reimburse at a higher rate for a newer, better treatment if there is already a treatment available for patients that costs significantly less,” said Matthew Cabrey, senior director of corporate communications for Shire Pharmaceuticals.

Shire, based in Dublin, is the maker of Adderall, a blockbuster drug for attention deficit hyperactivity disorder, or A.D.H.D. Five years ago, Shire began studies that compared its drugs with others on the market, analyzing its amphetamine-based A.D.H.D. medications against competing treatments widely prescribed in Europe.

“Financial conditions have highlighted and accelerated the need to demonstrate value for medicines,” Mr. Cabrey said.

He said that while conducting the extra tests had not directly increased Shire’s cost of doing business, it had significantly affected planning. Shire now considers the economics of pharmaceuticals much earlier in the development process. That can lead to certain medicines not being developed if it seems unlikely that the market will recognize their value.