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Day: November 4, 2020

Why Europe needs radical digital reform

EU attempts to curtail the influence of the world’s digital giants are stymying innovation, argues the Consumer Choice Center’s Maria Chaplia.

Amazon will soon face antitrust proceedings to address concerns raised by EU authorities regarding the company’s access and use of data. Specifically, they claim the American company can see sensitive commercial information on third-party products such as price or volume. Amazon’s actions would qualify as anti-competitive if the EU finds that it has been using this data to improve the ranking of its own products.

Regardless of the outcome of this investigation into abusive, monopolistic behaviour, the EU will come out as a loser if it does not undertake a radical digital reform to liberalise its digital single market. In the face of digital competitors from abroad, it has become convenient to pull out antitrust laws in response to every tech issue. But such an approach has neither made the EU more innovation-friendly nor more mindful of actual consumer needs.

Instead of letting digital services of all types develop at their own pace, the EU has relegated itself to passing legislation that is far from technology-neutral. According to EU Competition Commissioner Margrethe Vestager, the EU’s current regulations were put in place “when no one could have foreseen the situation we’re in today, that platforms would not just be channels, but full ecosystems where a lot of what is ongoing is monetised by the platform itself.” There was, of course, no way to predict what has happened, but it’s a poor justification for the EU’s digital lag.

Regulators, though with noble intentions, are simply unable to know ahead of time how far innovation can and will go. What they can do, instead, is create and sustain a framework that does not pick winners and losers, but safeguards intellectual property rights, keeps taxation low to encourage returns, limits barriers to entry, and makes investment easy.

In Europe, there are many outdated laws that make it burdensome to create new and innovative digital services before they ever hit the market. One example is the lack of a European-wide license for audiovisual services, forcing service providers to apply in every Member State if they want to show their content. It is the same for most other digital services in the EU, including music streaming or news collection.

“If the EU succumbs once more to antitrust legislation, it will come at the expense of future innovation and risk cutting off millions of European consumers from vital digital services”

Another key issue concerns taxation. The EU has long considered levying a tax of between two and six percent on the local revenues of platform giants. The prospect of trade talks with the US has brought this topic back into the spotlight. However, an EU-wide digital tax would limit potential future innovation. Innovators should be able to choose between high-taxed and low-taxed locations, not be faced with a uniform unavoidable tax. Complicated issues – such as the EU’s digital lag – require complex solutions according to officials, but that’s not the case. Less intervention means more innovation. Antitrust lawsuits and actions are a great tool for tax collecting but they don’t solve the core problem. We need a digital market that has many different options to choose from, making it less likely that one company can gain a monopoly as it will be more preoccupied with actual competition, and thus seek to come up with innovative solutions for consumers.

If the EU engages once more in antitrust proceedings, it will come at the expense of future innovation and risk cutting off millions of European consumers from vital digital services. We need reform and liberalisation in order to better provide for both consumers and producers.

Originally published here.

Give patients more access: We need zero VAT on medicines in Europe

As Europeans face a public health crisis, we should increase patient accessibility by abolishing VAT on the most essential of goods, writes Bill Wirtz.

The COVID-19 pandemic has put health policy back into the hearts and minds of European decision-makers. Before the outbreak, Europe had been in a debate about drug pricing, but it only involved the upper echelon of political institutions. Often blamed are pharmaceutical companies, as well as a lack of price transparency. But having a closer looks at the costs of drugs shows that one of the main drivers for high costs is sales taxes on medicines.

Informed patients will know that all but one European country charge VAT on over-the-counter (OTC) medicine and prescription medicine. Germany charges as much as 19% VAT on both types of medicines, while Denmark ranks the highest, with rates at 25% – that is a fifth of the total price for a drug!

There is only one country that does not charge VAT on prescription or over-the-counter drugs: Malta. Luxembourg (3% each) and Spain (4% each) also show that modest VAT rates on drugs are not a crazy idea but something millions of Europeans already benefit from. Sweden and the UK both charge 0% VAT on prescription medicine, yet 25% and 20% respectively on OTC.

One of the significant roadblocks towards more patient access to drugs is the unfair tax policies of some EU member states. Before talking about eroding intellectual property rights and price setting across the block, we should discuss whether we should have a VAT on medicines.

Especially on prescription medicine, where cancer drugs can reach substantial price levels, VAT rates of up to 25% significantly burden patients and their health insurance. On prescription medicine, there is little sense in first charging value-added tax, and then have national health insurance providers pick up the tab. As for OTC medicine, the implication that just because it isn’t prescribed, it therefore isn’t an essential good, is a blindspot of policy-makers.

Many OTC meds, ranging from drug headache pain relief, heartburn medicine, lip treatments, respiratory remedies, or dermatological creams are not only essential medicines for millions of Europeans; they often act as preventative care. The more we tax these goods, the more we are burdening MDs with non-essential visits.

Following the example of Malta, European countries should lower their VAT rates to 0% on all medicines. The purpose of VAT is to take a cut out of commercial activity, making sure that all commercial transactions pay what is considered their fair share, even those businesses who traditionally don’t pay any company taxes. However, regarding the sale of medicine as a purely commercial transaction, from the standpoint of patients, misses the point. Millions of patients need specific prescription medicine every day, and others rely on the help of over-the-counter drugs to relieve pain or treat problems that do not require professional medical attention.

It is time for European nations to agree on a binding Zero VAT agreement on medicine or at least a cap at 5%, which would reduce drug prices in the double digits, increase accessibility, and create a fairer Europe.

Originally published here.

Wir brauchen keine Mehrwertsteuer auf Medikamente in Europa

Da Europäer mit einer Krise der öffentlichen Gesundheit konfrontiert sind, sollten wir die Zugänglichkeit für Patienten verbessern, indem wir die Mehrwertsteuer auf Medikamente abschaffen.

Die Corona-Pandemie hat Gesundheitspolitik zur Chefsache der europäischen Entscheidungsträger gemacht. Vor dem Ausbruch gab es auf EU-Ebene bereits eine Debatte über Arzneimittelpreise. Häufig werden Pharmaunternehmen und mangelnde Preistransparenz dafür verantwortlich gemacht, dass Medikamente zu teuer sind. Ein genauerer Blick auf die Arzneimittelkosten zeigt jedoch, dass eine der Hauptursachen für hohe Kosten die Verkaufssteuern auf Medikamente sind.

Manche Patienten werden wissen, dass bis auf ein Land EU LänderMehrwertsteuer auf rezeptfreie und verschreibungspflichtige Medikamente erheben. Deutschland erhebt 19% Mehrwertsteuer auf beide Arten von Arzneimitteln, während Dänemark mit Sätzen von 25% – das ist ein Fünftel des Gesamtpreises für ein Medikament – am höchsten liegt.

Es gibt nur ein Land, das weder auf verschreibungspflichtige noch auf rezeptfreie Arzneimittel Mehrwertsteuer erhebt: Malta. Luxemburg (je 3%) und Spanien (je 4%) zeigen auch, dass bescheidene Mehrwertsteuersätze auf Medikamente keine verrückte Idee sind, sondern etwas, wovon bereits Millionen von Europäern profitieren. Schweden und das Vereinigte Königreich erheben beide 0% Mehrwertsteuer auf verschreibungspflichtige Arzneimittel, jedoch 25% bzw. 20% auf rezeptfreie Arzneimittel.

Eines der wesentlichen Hindernisse auf dem Weg zu mehr Patientenzugang zu Medikamenten ist die unfaire Steuerpolitik einiger EU-Mitgliedsstaaten. Bevor wir über die Schwächung von Patentrechten und europaweite Einheitspreise für Medikamente sprechen, sollten wir darüber diskutieren, ob wir eine Mehrwertsteuer auf Medikamente überhaupt erheben sollten.

Insbesondere bei verschreibungspflichtigen Medikamenten, wo Krebsmedikamente schnell richtig teuer werden, belasten Mehrwertsteuersätze von bis zu 25% Patienten und ihre Krankenversicherung erheblich. Bei verschreibungspflichtigen Medikamenten macht es wenig Sinn, zuerst die Mehrwertsteuer zu erheben und dann (meist) die öffentlichen Krankenkassen die Rechnung übernehmen zu lassen.

Viele OTC (over the counter)-Medikamente, die von der Linderung von Kopfschmerzen, Sodbrennen, Lippenbehandlungen, Atemwegsmitteln bis zu dermatologischen Cremes reichen, sind für Millionen von Europäern nicht nur wichtige Medikamente, sondern dienen häufig auch der Prävention. Je mehr wir diese Güter besteuern, desto mehr belasten wir die Ärzte mit nicht unbedingt notwendigen Besuchen. Komischerweise fällt bei Arzt- oder Krankenhausbesuch in Deutschland keine Umsatzsteuer an – Schwer ist aber zu verstehen warum diese dann auf Medikamente und Hilfsmittel erhoben wird. Was rezeptfreien Medikamente betrifft, so ist die Implikation, dass sie, nur weil sie nicht verschrieben werden, kein essentielles Gut sind, ein blinder Fleck der politischen Entscheidungsträger.

Dem Beispiel Maltas folgend, sollte Deutschland Medikamente von der Mehrwertsteuer befreien. . Der Zweck der Mehrwertsteuer besteht darin, einen Teil aus der kommerziellen Tätigkeit herauszunehmen und sicherzustellen, dass alle kommerziellen Transaktionen gerecht besteuert werden, auch jene Unternehmen, die traditionell keine Unternehmenssteuern zahlen. Den Verkauf von Medikamenten aus der Sicht der Patienten als eine rein kommerzielle Transaktion zu betrachten, verfehlt jedoch den Sinn. Millionen von Patienten benötigen täglich bestimmte verschreibungspflichtige Medikamente, und andere sind auf die Hilfe von rezeptfreien Medikamenten angewiesen, um Schmerzen zu lindern oder Probleme zu behandeln, die keine professionelle medizinische Behandlung erfordern.

Es ist an der Zeit, dass sich die europäischen Länder auf ein verbindliches Null-Mehrwertsteuer-Abkommen für Arzneimittel oder zumindest auf eine Obergrenze von 5% einigen, was die Arzneimittelpreise im zweistelligen Bereich senken, die Zugänglichkeit erhöhen und ein gerechteres Europa schaffen würde.

Originally published here.

To promote access to Covid-19 medicines, keep trade free and remove tax and regulatory obstacles

As member states of the World Health Organization gather next week in Geneva for the World Health Assembly, a global coalition of 29 think tanks today calls on governments to commit to simple reforms that will accelerate access to medicines, including those in the process of being developed for Covid-19.

Import tariffs, sales taxes and other levies are applied by many countries on medicines and vaccines, driving up prices and reducing availability. In many countries domestic taxes can make up 20-30% of the final price people pay for medicines, the declaration notes. These should be abolished permanently. 

Customs red tape should be reviewed to keep medicines crossing borders as quickly as possible, the declaration urges.

Patients wait of up to seven years for new treatments while waiting for national drug regulatory authorities to approve them, even if they have already been declared safe and efficacious by a stringent regulatory authority such as from the US food and Drug Administration (FDA) or European Medicines Agency (EMA). 

The declaration urges countries to reduce this duplication and speed medicines access by accepting the decisions of other regulatory authorities

Other measures recommended include asking governments to update their national formulary lists more frequently to take account of new medicines, and an end to protectionist measures that prioritise local companies, for example during procurement. Such “localised barriers to trade” reduce the number of medicines suppliers, leading to higher prices, fewer choices and shortages.

“As new treatments and vaccines for Covid-19 become available it is imperative they are made available globally as quickly as possible. Trade and regulatory barriers stand in the way in many countries. Fortunately, many of these barriers are easy to address so we urge countries to take action now” says the Consumer Choice Center. 

“Smoothing the path to Covid medicine access will also help patients who face long delays and tax-inflated medicine prices for all other diseases none of which have gone away.”

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Notes to editors:

To download the report, click here.

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