Parallel import increases freedom of choice. It also provides pharmacies, wholesalers and especially patients with the possibility to select the products with lowest price on the market. Without parallel import, taxpayers would be burdened with a larger share of the national healthcare scheme. Also, in many cases patients would be paying considerably more for their prescription medicines.

How much can be saved?

According to the estimates of the Finnish Association of Parallel Importers, parallel imported medicines can save millions each year. Direct savings come from price differences, when pharmacies provide a cheaper product, and indirect savings come from price competition brought about by parallel imports, as the prices of competing products decrease. This price competition brings about the biggest savings to the society and patients. Parallel imported medicines were included in the medicine substitution system on the 1st of April 2017, and after that the number of parallel imported products has increased significantly and price competition escalated. However, price competition does not yet work as efficiently as possible, and the market share of parallel imports has not grown meaningfully in Finland.

Finnish hospitals have been active for years in utilizing savings brought about by parallel imported medicines. Parallel imported medicines also have a more extensive effect on pharmaceutical expenses in hospitals. Including parallel importers in public tendering of the hospital districts lowers prices of the pharmaceuticals due to price competition.

According to a study commissioned by Suppliers of Parallel Imported Medicines in Finland in 2021, the share of parallel imported products of total pharmaceutical costs in hospitals was 5.6% in 2016-2020. In pharmacies, the share of parallel imported products was only 2%. In pharmacies, this share has grown from 2014 by only one and a half percentage points, whereas in hospitals, the share has grown steadily during the same period.

In Finland, the share of parallel imported products of all pharmaceutical sales is considerably smaller than in many other European countries: the share was only about 3% in 2016-2020. In Denmark, for example, the share of parallel imported pharmaceuticals in pharmacies was 30% and in hospitals 8% in 2021. In Sweden, the corresponding figures are 14% and 5%, and in Germany, the share of parallel importers of the whole pharmaceuticals market is about 8.5% (2016).

National health insurance systems save hundreds of millions of euros every year in countries where parallel import works, and price competition is possible. In these countries, parallel import has been permitted by various rules and regulations set by relevant national authorities. According to a study published in 2022 in Denmark, a country with a population of comparable size to Finland, parallel import generated savings of nearly €100 million in 2021. In Germany, the direct savings generated by parallel import are estimated at €300 million each year*.

Market shares: Reveal, Pharmarket, DLI-MI and Market Research Insight Health.

*Source: VAD (Verband der Arzneimittel-Importeure Deutschlands eV)

Study on savings from parallel import of pharmaceuticals in Finland 2016–2020

Suppliers of Parallel Imported Medicines in Finland have commissioned a study on savings from parallel import of pharmaceuticals to society and patients during 2016–2020. The study was conducted by Copenhagen Economics, an independent consultancy specialising in economics.

According to the study, the total savings from parallel import of pharmaceuticals in Finland during 2016–2020 amounted to €41 million. Since the average market share of parallel imported medicines in this period was 3%, the average savings from parallel imports were estimated to be approximately 8%. Most of the savings, around €32 million, occurred in the pharmacy sector, despite parallel importers having a market share of only around 2%. In the hospital sector, where the market share is approximately 5.6%, the corresponding savings were estimated to be around €10 million.

Savings from the parallel import of pharmaceuticals consist of direct and indirect savings. The direct savings due to the price difference between parallel imported and originally produced medicines were €17 million. Indirect savings that arise from the difference between the price of original products with competition and the estimated price without competition were €24 million. In other words, the competition created by parallel imports is assumed to reduce the prices charged by original manufactures and thereby leads to savings. Total savings benefit both patients and taxpayers. According to the study, patients saved €17 million and taxpayers €24 million.

Aside from direct and indirect savings, the study estimated that forgone savings during 2016–2020 amounted to €72 million. These savings would have materialised if patients had always bought the most affordable parallel imported medicine instead of the original products actually sold. The results suggest that there is ample room for further savings from parallel imports. The amount of savings potentially available can be affected through regulatory amendments.

Read the full report

Assessment of savings from parallel import of pharmaceuticals in Denmark in 2021

The Danish Association of Parallel Importers of Pharmaceuticals (Foreningen for Parallelimportører af Medicin) have commissioned a study on savings that parallel import of pharmaceuticals gave rise to in Denmark in 2021. The study was conducted by Copenhagen Economics, an independent consultancy specialising in economics.

According to the study, the total savings from parallel import of pharmaceuticals in Denmark in 2021 amounted to nearly €100 million. In the pharmacy sector, the average market share of parallel imported medicines was 30%, which is 15 times the share in the Finnish pharmacy sector (2%). In the hospital sector, the market share was approximately 8%. Therefore, most savings occurred in the pharmacy sector, where they amounted to more than €84 million. In the hospital sector, the estimated savings were more than €15 million.

The relatively large savings in the pharmacy sector are above all due to the more supportive regulatory environment in this sector compared to the hospital sector.

Read the full report

As a result of the Court’s decision, trademark owners can demand (if certain conditions are met) that parallel importers attach Finnish and Swedish labels on the imported foreign original packages instead of reboxing the products into completely new outer packages. When original packages are relabelled, text in a foreign language may remain visible.

In the relabelling process, the anti-tampering devices of the original outer package must be broken so that the inner packaging can be labelled according to the regulations by The Finnish Medicines Agency Fimea, and the foreign package leaflet replaced with a Finnish and Swedish package leaflet. Finally, the outer package is resealed and relabelled with Finnish and Swedish labels approved by Fimea. The unique identifier of the original package (2D code and its human readable format) is replaced with a new one.

The reference on the outer package to the repackager provides information about the origin of possible traces of opening of the package. This reference, together with the anti-tampering devices and the new unique identifier, makes it possible to verify the authenticity of the package in the pharmacy, despite the presence of possible traces of opening.

Relabelling of the original outer package is used in the Finnish market where applicable. Therefore, there are two methods of repackaging parallel imported and distributed products that are used in parallel: reboxing into a completely new outer package, and relabelling the original outer package using Finnish and Swedish labels.

What are interchangeable medicinal products and what is the medicine substitution system?

The Finnish Medicines Agency Fimea compiles a list of substitutable medicinal products and maintains it. Pharmaceuticals that contain the same quantity of the same active agent and are biologically equivalent are considered interchangeable. This list includes original products and parallel products (generic products) with marketing authorisation, parallel imports or parallel distribution products. Not all parallel products (generic products) are within the scope of the medicine substitution system (e.g. medicines for epilepsy and arrhythmia), but parallel imports and parallel distribution products are always interchangeable regardless their pharmaceutical form or ATC classification. In the medicine substitution system, the pharmacy substitutes the medicine prescribed by a doctor or dentist to the most affordable interchangeable medicine or one close to it in price.

What is the reference price system?

The reference price group of medicinal products is composed of reimbursable, interchangeable medicines that have marketing authorisation, provided the reference price group to be formed includes at least one parallel product, parallel imported product or parallel distribution product available commercially. In the reference price system, the pharmacy substitutes the medicine prescribed to the patient to the most affordable interchangeable product or to one that is no more than 0.5 € more expensive than the cheapest option. In the reference price system, reimbursement is paid according to the most affordable product or an interchangeable product with a minor price difference (+0.5 € = the reference price) to the cheapest one.

If the patient chooses to purchase a product that is more expensive than the reference price, the patient pays the difference between the reference price and the medicine’s price. If the doctor has forbidden changing the medicine, the reimbursement is calculated on the basis of the prescribed medicine. In the reference price system, the patient often chooses the more affordable option as it directly affects the medicinal costs of the patient.

Can anyone become a parallel importer and sell pharmaceutical products?

No, they cannot. Every pharmaceutical company, including parallel importers, must commit to all legislations and regulations which ensure that product documentation, production facilities, distribution and environmental concerns meet the high quality standards. A wholesale distribution license is also a mandatory requirement.

What enables parallel import?

Articles 28-30 of the EC Treaty determine the principle of free movement of goods, which enabled parallel import in the Nordic countries when they joined the EU/EEA. These articles prohibit artificial barriers for free movement of goods within the EU, as it is supposed to function as an integrated market just like individual countries.

Why do prices of pharmaceutical products vary between European countries?

Pharmaceutical companies are entitled to set different prices for their products in different markets. Governments attempt to control the prices of pharmaceutical products and this causes price differences between countries. In addition, the social security systems of countries differ, and each country evaluates pharmaceutical products differently, which also affects the prices of pharmaceutical products. Currency exchange rate fluctuations may also have an impact on the prices in different countries.

What are the benefits of parallel pharmaceutical imports?

The patient and the society benefit from parallel import. By bringing competition to the pharmaceutical market, parallel importers have been able to lower price level of pharmaceutical products, thus bringing direct and indirect savings to the patients and national health care. Without parallel import, many pharmaceutical products would be considerably more expensive.

How do parallel imported medicines differ from directly imported medicines?

Parallel imported medicines are the same products as the directly imported medicines. The only difference is that the parallel imported medicines have been manufactured for the use of another European country, and thus there may be differences in the name or the labelling compared to the directly imported product sold in Finland.

The process for the marketing authorization for parallel import ensures that the products are sufficiently similar. Parallel import is covered by the same legislation and regulations as other pharmaceutical products, ensuring that they are as safe and reliable as all other pharmaceutical products.