Effects of pharmaceutical cost containment policies on doctors’ prescribing behavior: Focus on antibiotics

Perception and attitude of Korean physicians towards generic drugs

“…Compared with the 2011 survey, the 2013 survey showed that the proportion of negative perception of generic drugs increased by nearly 20%; more than two-thirds ( n  = 210, 71%) had doubts about the safety and efficacy of generic drugs and only 15.3% believed that there was no difference in the safety and effectiveness between generic drugs and original drugs (Table 3). The results from this study were in line with the other surveys which were conducted by the Korean Medical Association newspaper in 2011 and 2015, [14, 15] which found that less than one-third of respondents (2011:30.3%; 2015:25%) believed that generic drugs were therapeutically equivalent to original drugs, or even to each other. Also, interestingly, almost all respondents in 2013 (93.6%) believed that there was difference in the safety and effectiveness between two generic drugs and only 6.4% of the respondents agreed with that some generic drugs were therapeutically equivalent to other generic drugs, to each other.…”

“…In the first year after patent expiration, the price of original drugs and generic drugs will be set at 70% and 59.5% of the original drug price respectively. Beginning in the second year after patent expiration, the price for all drugs will be set at 53.5% of the original drug price, regardless of the order of entry, eliminating differences between the prices of original drugs and generic drugs, as well as the difference in co-payments [13–15]. These rules were applied to 13,184 listed drugs, reducing the prices of 6504 drugs [14].…”

“…Therefore, the physicians’ opinions on drug policies can be a key factor to increase the use of rational and cost-effective drugs and play a pivotal role in implementing the different pharmaceutical policies [16]. Few studies have been performed in Korea to investigate physicians’ understanding of generic drugs and to evaluate their attitudes toward generic drugs prescription before and after the pricing policy reform [13–15, 17, 18]. Our surveys were conducted with registered doctors at the government-affiliated Health Insurance Review Agency (HIRA) in 2011 and 2013.…”

Addressing the challenge of high-priced prescription drugs in the era of precision medicine: A systematic review of drug life cycles, therapeutic drug markets and regulatory frameworks

“…On average, countries in the Organization for Economic Co-operation and Development (OECD) spend 17% of their health care budgets on pharmaceuticals;[ 24 ; 33 ] in some countries, this is even more. [ 25 ; 34 ] For low- and middle-income countries (LMIC), drug expenditure can be a critical public health problem[ 35 – 38 ] with some drugs out of reach for even well-insured patients. [ 26 ; 39 ] In some cases, to prevent striking increases in premiums or taxes, regulators are forced to limit access to healthcare,[ 13 ; 24 ; 40 – 42 ] which leaves patients without the best treatments.…”

“…This means that regulation can either aim to lower drug prices, or reduce usage. [ 34 ; 49 ; 50 ] On the one hand, there is a growing life expectancy (and aging population worldwide), while there are increasing medical options for disease control. [ 51 ; 52 ] Therefore, following drug innovation expectations and usage growth statistics, it is likely that costs will continue to rise.…”