Finnish register study links rising initial costs of new outpatient medicines to orphan, cancer and biologic products

A nationwide register study of new outpatient medicines entering Finland’s National Health Insurance reimbursement system between 2011 and 2021 found that the median initial cost of six months’ treatment rose from €1,209 in 2011 to €10,652 in 2021. The study, summarized in the available abstract, included 193 new medicines and reported that high initial costs were associated with orphan designation, oncological indication and biologic status rather than proving that those characteristics caused the higher costs.

Researchers identified newly reimbursed medicines and their six-month costs at the time of inclusion from Finland’s national register of reimbursed medicine purchases. They used statistical averages and distributions to describe the medicines and their initial costs. A linear regression model examined associations between initial costs and medicine characteristics. The analysis found that initial costs for medicines with orphan designation were 12.2 times higher than for other medicines (P < 0.001).

Almost one-third of the 193 medicines were cancer medicines, while 15% were described as first-of-kind medicines. The abstract also reports that the number of products entering the reimbursement system with limited evidence of benefits increased over the study period. This increase was an observed feature of reimbursement decisions; the available evidence does not establish that products with limited evidence were responsible for rising costs.

The findings are limited to the medicines included in the Finnish reimbursement system during 2011–2021 and to costs measured at the time of inclusion. The register-based design describes reimbursement patterns and statistical associations, but it does not determine whether the observed differences reflect clinical benefits, patient outcomes, budget effects or other factors. The available abstract does not report detailed adjustments for confounding, uncertainty around the cost estimates, a control group or a complete account of study limitations. It is also an abstract-level summary, and the publisher notes that the accessible research version remains subject to further edits before replacement by the final version of record.

Subject of Research: Trends in the initial costs and characteristics of new reimbursed outpatient medicines in Finland, 2011–2021

Article Title: A nationwide register study of new outpatient medicines: trends in initial costs and medicine selection in Finland, 2011–2021

Article References: Kaustiala, K., Rättö, H., Sarnola, K., Kurko, T., Wagner, A. K., & Koskinen, H. (2026). A nationwide register study of new outpatient medicines: trends in initial costs and medicine selection in Finland, 2011–2021. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15725-2

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15725-2

Keywords: Finland, outpatient medicines, drug reimbursement, health expenditures, orphan medicines, cancer medicines, biologic medicines, register study, initial treatment costs, nationwide, register, outpatient