Latvian Pharmaceutical Market and Medicine Tender Process The Latvian pharmaceutical market is sizeable comparative to its population and economic status. The market’s total value in 2021 was €442.5 million ($479.82 million), which was a decrease of 1.12% from previous year (approx. €5 million) due to the various impacts COVID-19 had on this market. In 2018, Latvia was 26th out of the 28 EU countries for annual market value, between Lithuania at €635 million ($689 million) and Estonia €299 million ($325 million). The CAGR is expected to be 8.75% up to 2030, where the market value is predicted to reach €2.35 billion ($2.55 Billion). Despite universal coverage through state funding, 37.1% of coverage is out-of-pocket, over double the European average (15%) and one of the highest rates on the continent. Much of this includes pharmaceutical procurement.

Despite this, the tender process is primarily influenced by the state, as well as through the Joint Baltic Drug Procurement Agreement, in which all member states (including Lithuania, Estonia and Latvia) subsidies specific drugs, in particular those which treat diabetes, HIV and Tuberculosis. Drug wholesalers determine prices by multiplying the manufacturer’s price by a correction factor, adding the correction sum and a VAT of 12%. The correction factor and the correction sum are determined on the basis of the manufacturer’s price. Once these pharmaceuticals are procured, they are added to a positive reimbursement list, which reimburses the service user 100%, 75% and 50% respectively. Where specific medication is listed is based on the disease it treats and how important that medication for vital functions of the patient; medication for rheumatoid arthritis, for example, is on list A, and is fully reimbursed. This only applies for outpatient services, however, as inpatient prescriptions are free of charge. Inpatient medication is procured by the health service provider directly, which is under the direct management of the Ministry of Health, which typically includes larger secondary and tertiary care centers. Smaller hospitals are controlled by municipalities, but 80% of these, as well as primary care centers, are privately owned.

Pharma14 tracks the Latvian monthly tender landscape.
Sample data: Dinutuximab Beta and Treprostinil January 2023 tender data.