Pharmaceutical policies: effects of reference pricing, other pricing, and purchasing policies

Aaserud, Morten; Austvoll‐Dahlgren, Astrid; Kösters, Jan Peter; Oxman, Andrew D; Ramsay, Craig R; Sturm, Heidrun

doi:10.1002/14651858.cd005979

Cited by 138 publications

(81 citation statements)

References 36 publications

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“…Despite initial concerns that this policy would result in a switch to less effective medications and increased noncompliance, a 2006 Cochrane review found no increase in adverse events or health care utilization. 11 However, the program has not expanded beyond the initial five medication classes owing to lobbying by the pharmaceutical industry, inconsistent evidence of sustainable health care savings and electoral politics. 12 Although policies for generic and therapeutic substitutions were created to decrease health care spending at a population level, they also result in lower out-of-pocket expenses for patients be cause less expensive drugs are favoured.…”

Section: Drug Formulariesmentioning

confidence: 99%

Addressing cost-related barriers to prescription drug use in Canada

Tang

Ghali

Manns

2013

CMAJ

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Section: Drug Formulariesmentioning

confidence: 99%

Addressing cost-related barriers to prescription drug use in Canada

Tang

Ghali

Manns

2013

CMAJ

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“…1 Different policies and practices have attempted to control and decrease medication costs, with varying results. 2 The use of less expensive generic versions of brand-name medications is an opportunity to contain costs. In Canada, generic drug prices are regulated, and most are set at 25%-56% of the proprietary drug cost.…”

mentioning

confidence: 99%

Patterns of use for brand-name versus generic oral bisphosphonate drugs in Ontario over a 13-year period: a descriptive study

et al. 2015

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Background:Bisphosphonates are the first-line therapy for the treatment of osteoporosis. In the province of Ontario, the Ontario Drug Benefit Program funds medications for patients aged 65 years and older. The Ontario Drug Benefit Program has a generic substitution policy that requires lower-cost generic drugs to be dispensed when they are available. However, there is controversy surrounding the efficacy and tolerability of generic bisphosphonates. The objective of this study was to describe patterns in the use of brand-name versus generic formulations when dispensing oral bisphosphonate over a 13-year period. Methods:We identified all osteoporotic preparations for alendronate and risedronate that were dispensed through the Ontario Drug Benefit Program from 2001 to 2014. We stratified our sample into community-dwelling residents and residents in long-term care facilities. The number of prescriptions dispensed per month were plotted to illustrate trends over time. Results:We found a rapid switch from brand-name to generic bisphosphonate equivalents immediately after the generic became available on the Ontario Drug Benefit formulary, with generics accounting for > 88% of dispensed drug within 2 months. We also observed a reduction in the number of generic drugs dispensed each time a new brand-name alternative (e.g., monthly risedronate, weekly alendronate plus vitamin D) was introduced to the formulary. The dispensing trends were similar in the community and longterm care settings. Interpretation:The Ontario Drug Benefit Program generic substitution policy resulted in rapid uptake of generic oral bisphosphonates among seniors in Ontario. However, there was a switch away from generic medications to new brand-name alternatives whenever they were introduced to the formulary. Therefore, some patients continued to use brand-name bisphosphonate despite the availability of generic options. Abstract E92CMAJ OPEN, 3(1)

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“…As to the impact of internal reference pricing, it has been reported to generate savings for third party payers due to an increase in co-payment, price reductions and reduced use of pharmaceuticals within the IRP scheme (Aaserud et al (2006), Espin and Rovira (2007)). IRP was found to have a limited impact on access, having increased out-of-pocket expenses and generating some supply problems.…”

Section: Internal Reference Pricing: Defining Reimbursement Ratesmentioning

confidence: 99%

Cost-Containment Policies in Public Pharmaceutical Spending in the EU

2012

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This paper presents and evaluates pharmaceutical policies in the EU aimed at the rational use of medicines and at keeping pharmaceutical spending under control. Policy makers are growing more aware that by regulating pharmaceutical markets correctly, considerable savings can be achieved without compromising the quality of care. Specifically, the paper makes the case that, by following numerous best-practices in pharmaceutical sector regulations, the value for money of pharmaceutical consumption could be substantially increased. Appropriate regulations can be relevant for pricing, reimbursement, market entry and expenditure control, as well as specific policies targeted at the distribution chain, physicians and patients.JEL classification: I11, I18.

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Pharmaceutical policies: effects of reference pricing, other pricing, and purchasing policies

Cited by 138 publications

References 36 publications

Addressing cost-related barriers to prescription drug use in Canada

Addressing cost-related barriers to prescription drug use in Canada

Patterns of use for brand-name versus generic oral bisphosphonate drugs in Ontario over a 13-year period: a descriptive study

Cost-Containment Policies in Public Pharmaceutical Spending in the EU

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