Essential to increase the use of generics in Europe to maintain comprehensive health care?

Abstract

<p>INTRODUCTION: Reforms have been introduced across Europe to increase prescribing efficiency with existing drugs. These include measures to lower prices of generics as well as increase their prescribing versus originators and patented products in a class or related class. This is essential to maintain comprehensive health care in Europe given continued pressures. The alternative is insufficient funds for new innovative drugs and increasing drug volumes with ageing populations. OBJECTIVE: To review the influence of measures and initiatives to increase the prescribing and dispensing of generics at low prices on ambulatory care prescribing efficiency. In view of this, provide guidance as authorities strive to introduce further reforms to meet their goals. METHODOLOGY: A narrative review of published papers combined with case histories. RESULTS: The different supply- and demand-side measures have reduced generic prices to as low as 2% to 3% of pre-patent loss prices in some cases as well as appreciably enhanced their utilisation. As a result, prescribing efficiency has increased without compromising care. In some cases, the reforms have led to expenditure actually falling despite appreciably increased volumes. CONCLUSIONS: Increasing use of generics at low prices will help maintain the European ideals of comprehensive and equitable health care. However, countries will continually need to learn from each other.</p

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

“…Growth rates averaging 50% in real terms during the past decade (1-3) has resulted in multiple reforms across countries. This growth has been driven by well-known factors including ageing populations and new premium priced drugs (1,2,(4)(5)(6). Initiatives for new medicines include models to better manage the entry of new medicines to optimise the use of available resources (6)(7)(8).…”

How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries

“…Evidence shows that generics have contributed to increased utilization of medicines [101,110]. In contrast to other policies described above, generics polices describe an area for which evidence on their effectiveness to ensure affordable access is available.…”

“…There is a large body of literature, including on European countries, that confirmed the savings' potential through lower prices by implementing generics policies [101,[107][108][109].…”

“…Overall, competitive pricing policies, including tendering, as used in some Nordic European countries, appear to be more successful than other, more regulated generic policies in reducing the price levels of generics as well as of competitor originators as well as increasing generics' uptake, in particular if coupled them with demandside measures [96,101]. The quality of generics is ensured in the EU Member States and neighbouring European countries, but lack of trust into the quality of generics by patients and even health professionals is still an issue [94,102,103].…”

How do regional sickness funds encourage more rational use of medicines, including the increase of generic uptake? A case study from Austria

“…Public education programmes have been introduced in some countries [8], such as the antibiotics campaign in France [9] and the generics campaigns in France and Portugal [10][11][12][13].…”