Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

Leopold, Christine; Mantel‐Teeuwisse, Aukje K.; Vogler, Sabine; Valkova, Silvia; Joncheere, Kees de; Leufkens, Hubert G. M.; Wagner, Anita K.; Ross‐Degnan, Dennis; Laing, Richard

doi:10.2471/blt.13.129114

Cited by 41 publications

(23 citation statements)

References 20 publications

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“…Between 2008 and 2015, in the wake of the global economic recession, several European governments implemented generic drug policies to help control costs . During this period, Slovakia introduced voluntary generic prescribing, which was previously forbidden.…”

Section: Discussionmentioning

confidence: 99%

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

2017

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Policy Points: Our study indicates that there are opportunities for cost savings in generic drug markets in Europe and the United States.Regulators should make it easier for generic drugs to reach the market.Regulators and payers should apply measures to stimulate price competition among generic drugmakers and to increase generic drug use.To meaningfully evaluate policy options, it is important to analyze historical context and understand why similar initiatives failed previously. ContextRising drug prices are putting pressure on health care budgets. Policymakers are assessing how they can save money through generic drugs.MethodsWe compared generic drug prices and market shares in 13 European countries, using data from 2013, to assess the amount of variation that exists between countries. To place these results in context, we reviewed evidence from recent studies on the prices and use of generics in Europe and the United States. We also surveyed peer‐reviewed studies, gray literature, and books published since 2000 to (1) outline existing generic drug policies in European countries and the United States; (2) identify ways to increase generic drug use and to promote price competition among generic drug companies; and (3) explore barriers to implementing reform of generic drug policies, using a historical example from the United States as a case study.FindingsThe prices and market shares of generics vary widely across Europe. For example, prices charged by manufacturers in Switzerland are, on average, more than 2.5 times those in Germany and more than 6 times those in the United Kingdom, based on the results of a commonly used price index. The proportion of prescriptions filled with generics ranges from 17% in Switzerland to 83% in the United Kingdom. By comparison, the United States has historically had low generic drug prices and high rates of generic drug use (84% in 2013), but has in recent years experienced sharp price increases for some off‐patent products. There are policy solutions to address issues in Europe and the United States, such as streamlining the generic drug approval process and requiring generic prescribing and substitution where such policies are not yet in place. The history of substitution laws in the United States provides insights into the economic, political, and cultural issues influencing the adoption of generic drug policies.ConclusionsGovernments should apply coherent supply‐ and demand‐side policies in generic drug markets. An immediate priority is to convince more physicians, pharmacists, and patients that generic drugs are bioequivalent to branded products. Special‐interest groups continue to obstruct reform in Europe and the United States.

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Section: Discussionmentioning

confidence: 99%

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

2017

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“…In this sense and, partially, in response to the economic crisis of 2008, the majority of European countries implemented pharmaceutical sector reforms in order to contain public expenditure on pharmaceuticals [5]. Policies to further increase the market share of generics were among the most frequent measures introduced [6,7].…”

Section: Introductionmentioning

confidence: 99%

Views of physicians and patients with chronic conditions on generic medicines in Greece after the introduction of measures to promote their consumption: findings from a qualitative study

Karampli¹,

Triga²,

Tsiantou³

et al. 2016

GaBI J

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Introduction/Study objectives: Generic medicines uptake is widely acknowledged as a key pharmaceutical policy measure towards cost containment and rational resource allocation. In Greece, due to the persistently low penetration of generics in the pharmaceutical market, a series of policy measures aiming to reverse this trend were implemented during the last years. The aim of the present study was to explore the perceptions and experiences of physicians and patients towards generic medicines as well as the acceptability of the policies implemented. Methods: A qualitative approach, based on semi-structured interviews to physicians and chronically ill patients residing in the region of Attica formed the basis of the analysis. Recruitment of physicians and patients was performed using a combination of convenience and snowball sampling techniques. Interviews were audio-recorded, transcribed and content analysed, according to international guidelines for qualitative research. Results/Discussion: Nine physicians (general internists and cardiologists), and nine patients suff ering from hypertension, diabetes mellitus and hyperlipidemia participated in the survey. Physicians' views on generics were positive, although concerns were raised regarding the monitoring mechanisms and the reliability of companies producing generics. Patients were more hesitant to express their opinion on generics because they felt that they were not adequately informed. Prescribing is a multi-criteria decision, whereas for patients the choice of medicine is made by their physician. Cost was not an important factor for both groups. Policy measures on generics were generally acceptable in the case of physicians and there were mixed opinions in the group of patients. Both groups stressed the need for more and reliable information regarding generics. Conclusion: Patient and physician attitudes can 'make or break' even a perfectly planned healthcare policy. Taking into consideration the information available in studies such as the present one, can aid decision-makers towards the design and implementation of viable policies in the sensitive fi eld of generics uptake.

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“…In a recent study on utilization of antipsychotics in Greece, the use of generics in 2009 was only 4% 18 . After the financial crisis that hit Greece since early 2010 onwards, a series of measures were implemented to contain public medicines expenditure, including price cuts, changes in reimbursement rates, delisting, internal reference price, international nonproprietary name (INN) prescribing 6,17 . Although prices of generics were cut by only 10% (before being equal to reference drug prices) 19 , the implemented measures encouraged generic prescribing 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Under the current financial crisis, an effort has been made by the Greek health authorities to encourage generic prescribing in order to lower medicinal cost [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Antipsychotics use in the community of Thessaloniki, Greece

Papaioannidou

Kasviki

2018

VOJNOSANIT PREGL

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Background/Aim. Under the current financial crisis in Greece, an effort has been made by the Greek health authorities to encourage generic prescribing, in order to lower medicinal cost. The purpose of this work was to study antipsychotics use, and to calculate utilization of generics in antipsychotics sales in a sample from the medicines market of Thessaloniki, the second largest city in Greece. Methods. A sample of antipsychotics registered sales was collected using the new Electronic Health Records that have been applied in pharmacies during the last years in Greece. The sample corresponded to a small amount of sales from the market of Thessaloniki during the period July 2014-June 2015, including only community and no hospital sales. All brand names (prototype and generics) of antipsychotics and their relative ratios in the sales were estimated, and the percentage of generics in the sale of each medicine was calculated. The amount of medicines was estimated in Defined Daily Doses (DDDs) of the reference/prototype drug and its generics. Results. Olanzapine, quetiapine, haloperidol and risperidone sales corresponded to 77% of total antipsychotics sales with percentages of sales 25%, 19%, 19% and 14% respectively. The percentage of sales of other antipsychotics was 7% for amisulpride, 6% for aripiprazole, 4% for ziprasidone and 3% for clozapine. Generic use corresponded to 41% of total sales of antipsychotic drugs (10.884 DDDs out of 26.433 DDDs). Concerning second generation antipsychotics, generic use was high for amisulpride, olanzapine, risperidone and quetiapine. Conclusion. In the study sample, second generation antipsychotics corresponded to 78% of sales in the community of Thessaloniki. Haloperidol utilization was also notable. Considering Greek practices, the percentage of generics in antipsychotics sales was very high even for some of the newest antipsychotics.

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Effect of the economic recession on pharmaceutical policy and medicine sales in eight European countries

Cited by 41 publications

References 20 publications

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

Comparing Generic Drug Markets in Europe and the United States: Prices, Volumes, and Spending

Views of physicians and patients with chronic conditions on generic medicines in Greece after the introduction of measures to promote their consumption: findings from a qualitative study

Antipsychotics use in the community of Thessaloniki, Greece

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