Payers endorse generics to enhance prescribing efficiency: impact and future implications, a case history approach

European payer initiatives to reduce prescribing costs through use of generics

“…For example, in Germany, the reimbursed prices for generics are appreciably higher than seen in UK, which limited potential savings in reality [38]. The limited number of demand-side measures in Portugal also reduced their efficiency gains from recent initiatives to lower generic prices [3,5,8].…”

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

“…The lack of regulation on generics promotion regulation (no INN prescribing, no generics substitution, no reference price system [23]) is likely to be a barrier for sickness funds, because they have to motivate doctors to prescribe generics whereas, in other countries with mandatory generics substitution this would not be an issue. It has been shown that generics substitution or INN prescribing, particularly if introduced as a mandatory measure, has a positive effect on generics uptake and lowering of prices [24,25,36,[65][66][67][68][69][70][71][72][73]. Furthermore, patients in Austria are not offered incentives to ask explicitly for generics.…”

“…Generic medicines help reduce the costs incurred by public payers [6,21] and are, in accordance with the WHO Nairobi declaration [1], a way of supporting rational use of medicines. It seems, however, that generics policies are not fully exploited in some European countries [22][23][24][25]. Policies to promote generics uptake, which is defi ned as the increase in the use of generics compared with the originator or patent medicines within a substitutable class, include the promotion of generics substitution at all levels of the health system, and the promotion of generics acceptance by professionals, patients, and the general community [26][27][28].…”

Health authority perspective on biosimilars

“…Key areas include the fact that healthcare systems are under increasing resource pressures due to well-known factors, including an ageing population, stricter clinical treatment targets and the continued launch of new premium priced drugs [2,3]. The latter includes new biological drugs, with almost 300 identifi ed in a quick internet search [1].…”

“…These can cost up to US$25,000/patient/month [4], in part, due to the complexity of production [1]. Their costs have become more visible in recent years with many standard oral drugs now available as low cost generics [2,3]. Sweden has seen low prices for generics with mandatory generics substitution with the lowest cost generics [1,3], and more recently with monthly auctions [3].…”