2023-02-222022/23:SoU6 · p.2SoUHealth & social services
Excessive prices on medicines
Overpricing of medicines outside the pharmaceutical benefits scheme
What's at stake: The issue concerns whether patients, parents of children with special dietary needs, and other adults may face high prices for medicines and special foods that are subsidized by the state or regions but not covered by the pharmaceutical benefits scheme.
Case texts and AI reasoning are AI-translated from the Swedish originals; the Swedish text is authoritative.
What the vote decides
The vote concerns whether the government should now commit to presenting a proposal regulating pharmacies' ability to charge overpriced amounts for medicines and special foods outside the pharmaceutical benefits scheme, or whether the matter should wait until ongoing inquiries are complete.
Yes Yes — the committee proposal
The committee shares the government's view that there is reason to consider rules against overpricing, but wants to await the ongoing inquiry into subsidizing special foods for children before parliament takes any initiative, and therefore rejects the motion.
No No — the reservations
Reservation 3 (S, V, MP)
S, V and MP argue that the issue is broader than special foods for children, that neither parents nor other adults should have to pay overpriced amounts for medicines, and want the government to make clear its intention to return with a proposal regulating excess profits at public expense.
Summarised from the committee report. Party labels in the summary come from the report, not from the vote.
What do the votes mean here?
Yes The committee proposal: rejecting the motions (keeping things as they are).
No Backing the counter-proposal: reservation 3 by S, V, MP.
Abstain The party marks a position of its own that is not one of the two final alternatives.
What each plan points to — and how the party voted
For each party: the vote its own election manifesto and party programme point to in this case, next to how the party actually voted. A plan can only point to Yes or No; a party can also abstain.
| Plan | Vote | Confidence | Evidence | ||
|---|---|---|---|---|---|
| V | No | No 0/21/0/3 | follows the plan | confidence: high | explicit |
| S | No | No 0/92/0/15 | follows the plan | confidence: medium | not addressed |
| MP | No | No 0/14/0/4 | follows the plan | confidence: medium | not addressed |
| C | No | Yes 20/0/0/4 | departs from the plan | confidence: medium | not addressed |
| L | No | Yes 14/0/0/2 | departs from the plan | confidence: low | not addressed |
| KD | No | Yes 15/0/0/4 | departs from the plan | confidence: medium | not addressed |
| M | Yes | Yes 58/0/0/10 | follows the plan | confidence: low | not addressed |
| SD | No | Yes 63/0/0/10 | departs from the plan | confidence: medium | not addressed |
Committee proposal
Parliament rejects motion 2022/23:2293 by Ulrika Westerlund (MP) demand 1.
Original (Swedish)
Riksdagen avslår motion 2022/23:2293 av Ulrika Westerlund (MP) yrkande 1.
Riksdag decision: Parliament has considered a submission from the government. It concerns the National Audit Office's review of the Medical Products Agency's supervision of open-care pharmacies and pharmaceutical wholesale trade. The report covers supervision by the Medical Products Agency, the Inspectorate for Care and Support (Ivo), and the Dental and Pharmaceutical Benefits Board (TLV). The National Audit Office's conclusion is that the state supervision over the pharmacy sector and pharmaceutical trade is not effective. This can lead to both pharmacies and those who buy and sell medicines risking operating businesses that do not meet legal requirements. The consequence can then be that patient safety suffers and expenses for the state and regions become unnecessarily large. In the submission, the government welcomes the review and is positive to several of the proposed measures that the National Audit Office provides. Among other things, the government argues that there are reasons to consider whether regulations should be introduced to prevent pharmacies from charging excessive prices on medicines that are not included in the pharmaceutical benefits but are subsidized by the state or regions and on special diet for children. Parliament largely shares the government's assessments and argues that it is central that supervision can be carried out effectively. With this, parliament laid the submission to the records, that is, closed the case.
Counter-proposals
- The counter-proposal wants to strengthen supervision of the pharmacy market through enhanced data-sharing between authorities and increased reporting obligations for irregularities. (S, V, MP) — Reservation 3
Plan vs actual vote
Every party, in chamber order: what its own plan pointed to, how it voted, and the reasoning behind both. Highlighted rows are where the two differ — but a vote that follows the plan is a result too, so the reasoning is there for every party.
The plan wants to ban profit-driven activities in welfare and states that tax revenues should go to operations and not to corporate profits, and that welfare should be decommodified.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan wants to ban profit-driven activities in welfare and states that tax revenues should go to operations and not to corporate profits, and that welfare should be decommodified. Regulating excessive profits at the expense of the public, more broadly than special food for children, follows directly from this.
Original (Swedish)
Planen vill förbjuda vinstdrivande verksamhetsformer i välfärden och slår fast att skattemedlen ska gå till verksamhet och inte till företagens vinster, samt att välfärden ska avkommersialiseras. Att reglera övervinster på det allmännas bekostnad, bredare än specialkost till barn, följer direkt av detta.
- ban on profit in welfaredecisive»Vänsterpartiet vill införa ett totalförbud mot alla vinstdrivande verksamhetsformer inom välfärden.« (2022 manifesto ↗)“The Left Party wants to introduce a total ban on all profit-driven activities in welfare.”
- tax revenues to operations»En vård och omsorg som är solidariskt finansierad av skattemedel och där pengarna går till verksamhet och inte till företagens vinster är en grundförutsättning för att uppnå en jämlik vård i hela Sverige.« (2022 manifesto ↗)“Care and support financed in solidarity by tax revenues, where money goes to operations and not to corporate profits, is a fundamental prerequisite for achieving equitable care throughout Sweden.”
- decommodified welfare»Vi vill att välfärden avkommersialiseras« (party programme ↗)“We want welfare to be decommodified”
- unequal access to medicine»I stora delar av Sverige är det svårt att få tag på medicin, fast i storstädernas rikare områden finns det flera olika apotek i varje gathörn.« (2022 manifesto ↗)“In large parts of Sweden it is difficult to get hold of medicine, while in the richer areas of major cities there are several different pharmacies on every street corner.”
The plan states that tax money should not enrich profit interests instead of securing welfare and that funds provided to welfare should also be used there.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan states that tax money should not enrich profit interests instead of securing welfare and that funds provided to welfare should also be used there. Overprices and excess profits on medicines at the public's expense contradict this and the fact that care supply should not be determined by producers' profit interests. Therefore, the requirement for regulation of excess profits is supported.
Original (Swedish)
Planen slår fast att skattepengar inte ska göda vinstintressen i stället för att säkra välfärden och att de medel som tillförs välfärden också ska användas där. Överpriser och övervinster på läkemedel på det allmännas bekostnad strider mot detta och mot att vårdens utbud inte får bestämmas av producenters vinstintresse. Därför stöds kravet på reglering av övervinster.
- tax money should not become profitsdecisive»Svenska folket ska styra över svensk välfärd och pengar ska inte göda riskkapitalister i stället för att säkra välfärden i hela vårt land.« (2022 manifesto ↗)“The Swedish people should control Swedish welfare and money should not enrich venture capitalists instead of securing welfare in our entire country.”
- care not on market terms»Tillgången till skola, vård och omsorg får aldrig avgöras av marknadens prismekanismer och utbudet får aldrig bestämmas av enskilda producenters intresse av egen vinst.« (party programme ↗)“Access to school, care and services must never be determined by market price mechanisms and supply must never be determined by individual producers' profit interests.”
- tax money stays in welfare»En grundprincip ska vara att de skattemedel som tillförs välfärden också används i välfärden.« (party programme ↗)“A basic principle should be that tax funds provided to welfare are also used in welfare.”
- limited profit interest»Dessa ska försäkra att verksamheten drivs med hög kvalitet, att vinstintresset begränsas och inte fungerar styrande för verksamheten, samt att de anställda har samma rättigheter och samma skydd oavsett driftsform.« (party programme ↗)“These should ensure that operations are run with high quality, that profit interests are limited and do not function as steering for operations, and that employees have the same rights and same protection regardless of operational form.”
The party programme states that long-term thinking and balance shall be prioritized before short-term profit interests, that public funds shall be used for the activities they are intended for and that monopoly formation shall be countered.
Plan documents: party programme
Reasoning and quotes
The party programme states that long-term thinking and balance shall be prioritized before short-term profit interests, that public funds shall be used for the activities they are intended for and that monopoly formation shall be countered. Overprices and excess profits on medicines funded by the public runs counter to this. The plan therefore supports the demand for regulation of excess profits, broader than just specialized food for children.
Original (Swedish)
Partiprogrammet slår fast att långsiktighet och balans ska prioriteras före kortsiktiga vinstintressen, att skattemedel ska användas till den verksamhet de är avsedda för och att monopolbildningar ska motverkas. Överpriser och övervinster på läkemedel bekostade av det allmänna strider mot detta. Planen stöder därför kravet på reglering av övervinster, bredare än enbart specialkost till barn.
- profit interests subordinateddecisive»och balans ska prioriteras före kortsiktiga vinstintressen.« (party programme ↗)“and balance shall be prioritized before short-term profit interests.”
- public funds for intended purposes»Det som är viktigt är kvaliteten på välfärden, att skattemedel används till den« (party programme ↗)“What matters is the quality of welfare, that public funds are used for the”
- counter monopoly pricing»Monopol- och kartellbildningar ska motverkas« (party programme ↗)“Monopoly and cartel formation shall be countered”
- control of the pharmaceutical sector»läkemedelskonsumtionen i dag är ett problem både« (party programme ↗)“medicine consumption today is a problem both”
The plan establishes that politics should use taxpayers' money carefully and that care should be provided according to need, not ability to pay.
Plan documents: 2022 manifesto · party programme
Reasoning and quotes
The plan establishes that politics should use taxpayers' money carefully and that care should be provided according to need, not ability to pay. It also sets quality requirements and profit distribution in publicly funded activities and wants to dampen prices through better competition. The government returning with proposals against excessive profits and overprices on medicines at public expense follows from these commitments.
Original (Swedish)
Planen slår fast att politiken ska hushålla med skattebetalarnas pengar och att vård ska ges efter behov, inte efter betalningsförmåga. Den ställer också krav på kvalitet och vinstutdelning i offentligt finansierad verksamhet och vill dämpa priser genom bättre konkurrens. Att regeringen återkommer med förslag mot övervinster och överpriser på läkemedel på det allmännas bekostnad följer av dessa åtaganden.
- careful use of tax fundsdecisive»Politiken ska hushålla med skattebetalarnas pengar. Mer pengar ska läggas på välfärdens kärna, mindre på bidrag.« (2022 manifesto ↗)“Politics should use taxpayers' money carefully. More money should go to the core of welfare, less to subsidies.”
- care according to need»att snabbt få vård i den offentligt finansierade sjukvården ska ges efter behov och inte efter betalningsförmåga.« (party programme ↗)“that access to rapid care in publicly funded healthcare should be according to need and not ability to pay.”
- requirements on profit distribution»Vi vill bland annat se höga kvalitetskrav för fortsatt verksamhet och vinstutdelning, och vi vill skärpa tillsynen av skolor och deras ägare.« (2022 manifesto ↗)“We want to see, among other things, high quality requirements for continued operation and profit distribution, and we want to strengthen supervision of schools and their owners.”
- competition dampens prices»Genom att skapa friare marknader och förbättra konkurrensen kan vi dämpa priserna ytterligare.« (2022 manifesto ↗)“By creating freer markets and improving competition, we can further dampen prices.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan has no writing on drug price markups, but establishes that care shall be paid for through the tax bill and that public procurement shall give taxpayers low costs.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan has no writing on drug price markups, but establishes that care shall be paid for through the tax bill and that public procurement shall give taxpayers low costs. The plan is also explicit that short-term profit withdrawals must not take precedence over the public purpose, and that private power can also be abused. Regulating excess profits at the public's expense thus aligns with the plan.
Original (Swedish)
Planen har ingen skrivning om överpriser på läkemedel, men slår fast att vård ska betalas över skattsedeln och att offentliga inköp ska ge skattebetalarna låga kostnader. Planen är också uttrycklig om att kortsiktiga vinstuttag inte får gå före det allmännas syfte, och att även privat makt kan missbrukas. Att reglera övervinster på det allmännas bekostnad ligger därför i linje med planen.
- low costs for taxpayersdecisive»Offentlig upphandling ska ske på sätt som ger skattebetalarna låga kostnader« (party programme ↗)“Public procurement shall be conducted in a way that gives taxpayers low costs”
- stop short-term profit withdrawals»Vi vill se en ny friskolereform med en samlad friskolelag som sätter stopp för friskolor där kortsiktiga vinster går före elevernas kunskaper.« (2022 manifesto ↗)“We want to see a new independent school reform with a consolidated independent school law that stops independent schools where short-term profits take precedence over student knowledge.”
- tax-financed care»Vård och omsorg ska i huvudsak betalas över skattsedeln« (party programme ↗)“Care and assistance shall mainly be paid for through the tax bill”
- private power can be abused»Även den privata makten kan missbrukas.« (party programme ↗)“Private power can also be abused.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan states that pharmaceuticals should be covered by a solidaristic financed system, that access to care shall never become an economic matter and that care shall be cost-effective.
Plan documents: party programme
Reasoning and quotes
The plan states that pharmaceuticals should be covered by a solidaristic financed system, that access to care shall never become an economic matter and that care shall be cost-effective. Overprices borne by individuals or the public conflict with this, as do the requirement for effective competition policy. The plan therefore supports that excess profits at public expense are regulated.
Original (Swedish)
Planen slår fast att läkemedel ska omfattas av ett solidariskt finansierat system, att tillgången till vård aldrig får bli en ekonomisk fråga och att vården ska vara kostnadseffektiv. Överpriser som bärs av enskilda eller av det allmänna strider mot detta, liksom mot kravet på en effektiv konkurrenspolitik. Planen stöder därför att övervinster på det allmännas bekostnad regleras.
- solidaristic pharmaceutical financingdecisive»Läkemedel ska efter särskilt godkännande omfattas av ett solidariskt finansierat system.« (party programme ↗)“Pharmaceuticals shall after special approval be covered by a solidaristically financed system.”
- care independent of finances»Det får aldrig bli en ekonomisk fråga om man ska kunna få tillgång till den service, vård och omsorg man behöver.« (party programme ↗)“It shall never become an economic matter whether one can get access to the service, care and support one needs.”
- cost-effective care»Den solidariskt finansierade hälso- och sjukvården ska vara ändamålsenlig och kostnadseffektiv, säker för patienterna och baserad på kunskap och beprövad erfarenhet« (party programme ↗)“The solidaristically financed health and medical care shall be purposeful and cost-effective, safe for patients and based on knowledge and proven experience”
- counter oligopoly»En effektiv konkurrenspolitik motverkar oligopol, monopol och illojal konkurrens.« (party programme ↗)“Effective competition policy counters oligopoly, monopoly and disloyal competition.”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
The plan has no commitment to regulating prices or profits on medicines.
Plan documents: party programme · 2022 manifesto
Reasoning and quotes
The plan has no commitment to regulating prices or profits on medicines. Its basic stance is that risk-taking should be rewarded and that the state's role in the economy is to promote competition, not to legislate away excess profits. The requirement for value for tax money exists in the plan, but the way to achieve it is prioritisation and competition rather than profit regulation, which is why the plan speaks against the counter-proposal's demand.
Original (Swedish)
Planen har inget åtagande om att reglera priser eller vinster på läkemedel. Dess grundhållning är att risktagande ska belönas och att statens roll i ekonomin är att främja konkurrens, inte att lagstifta bort övervinster. Kravet på valuta för skattepengarna finns i planen, men vägen dit är prioritering och konkurrens snarare än vinstreglering, varför planen talar mot motförslagets krav.
- risk-taking should be rewardeddecisive»Risktagande ska därför belönas.« (party programme ↗)“Risk-taking should therefore be rewarded.”
- competition before price regulation»skydda penningvärdet, främja konkurrensen« (party programme ↗)“protect the value of money, promote competition”
- value for tax money»Du som betalar in skatt ska också få valuta för dina inbetalade skattepengar.« (2022 manifesto ↗)“You who pay in tax should also get value for your paid tax money.”
- political prioritisation»Politiken har en viktig uppgift att prioritera och välja bort« (party programme ↗)“Politics has an important task to prioritise and make choices”
The plan's overarching commitment is that public funds shall be used effectively and that taxpayers' money never be used for waste, with clear results requirements for each investment.
Plan documents: 2022 manifesto
Reasoning and quotes
The plan's overarching commitment is that public funds shall be used effectively and that taxpayers' money never be used for waste, with clear results requirements for each investment. Excessive profits on the public account in pharmaceutical purchases are precisely the kind of leakage of tax money the plan wants to stop. The plan says nothing about the committee's reason to wait for an ongoing investigation into special foods.
Original (Swedish)
Planens genomgående åtagande är att offentliga medel ska användas effektivt och att skattebetalarnas pengar aldrig ska gå till slöseri, med tydliga resultatkrav för varje satsning. Övervinster på det allmännas bekostnad vid läkemedelsinköp är precis en sådan läckage av skattemedel som planen vill stoppa. Planen säger inget om utskottets skäl att en pågående utredning om speciallivsmedel bör inväntas.
- no waste of tax moneydecisive»Skattebetalarnas pengar ska aldrig användas till slöseri.« (2022 manifesto ↗)“Taxpayers' money shall never be used for waste.”
- effective use of public funds»Offentliga medel ska användas effektivt till verksamhet som tydligt skapar värde för medborgarna.« (2022 manifesto ↗)“Public funds shall be used effectively for activities that clearly create value for citizens.”
- results requirement on investments»Begära tydliga resultat för varje offentlig satsning« (2022 manifesto ↗)“Demand clear results for each public investment”
The plan takes no explicit position on what the committee actually decided — often because the committee's reason was procedural. The stance is derived and fully cited, but it does not show the party broke a commitment.
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Sources and documents
- The committee report on riksdagen.se (2022/23:SoU6)
- Committee report full text (HA01SoU6)
- Per-MP voting data (API)
- Case status (API)
Documents under consideration
- Motion 2022/23:2287 — med anledning av skr. 2022/23:12 Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel av Karin Rågsjö m.fl. (V)
- Motion 2022/23:2292 — med anledning av skr. 2022/23:12 Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel av Anders W Jonsson m.fl. (C)
- Motion 2022/23:2293 — med anledning av skr. 2022/23:12 Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel av Ulrika Westerlund (MP)
- Regeringens skrivelse 2022/23:12 — Riksrevisionens rapport om statens tillsyn över apotek och partihandel med läkemedel
Source: The Swedish Parliament