Price, familiarity, and availability determine the choice of drug - a population-based survey five years after generic substitution was introduced in Finland

Shannon

et al. 2013

BMC Pharmacol Toxicol

186

164

Generic medicines are those where patent protection has expired, and which may be produced by manufacturers other than the innovator company. Use of generic medicines has been increasing in recent years, primarily as a cost saving measure in healthcare provision. Generic medicines are typically 20 to 90% cheaper than originator equivalents. Our objective is to provide a high-level description of what generic medicines are and how they differ, at a regulatory and legislative level, from originator medicines. We describe the current and historical regulation of medicines in the world’s two main pharmaceutical markets, in addition to the similarities, as well as the differences, between generics and their originator equivalents including the reasons for the cost differences seen between originator and generic medicines. Ireland is currently poised to introduce generic substitution and reference pricing. This article refers to this situation as an exemplar of a national system on the cusp of significant health policy change, and specifically details Ireland’s history with usage of generic medicines and how the proposed changes could affect healthcare provision.

Section: A Brief History Of Pharmaceutical Regulationsmentioning

confidence: 99%

A review of the differences and similarities between generic drugs and their originator counterparts, including economic benefits associated with usage of generic medicines, using Ireland as a case study

Shannon

et al. 2013

BMC Pharmacol Toxicol

186

164

Journal of Pharmaceutical Health Services Research

“…The patients who had substituted their medicines had not noticed any differences between the previously used and substituted medicines. Price, availability and familiarity were the three most important factors that influenced their choice of medicines, whereas the external characteristics, for instance the colour and shape of the tablet/capsule or the appearance of the package, were not significant characteristics for people …”

Section: Generic Substitution In Finlandmentioning

confidence: 99%

Generic substitution in Finland: lessons learned during 2003-2008

Timonen

Heikkilä

Ahonen

2013

Self Cite

Objectives Obligatory generic substitution (GS) was introduced in Finland in 2003 with the aim of containing medicine costs. In this article The materialized impacts of GS are compared with the impacts that were anticipated before GS was introduced. The implementation of GS in Finland is described from the perspectives of generated savings, patients, physicians and the pharmaceutical distribution chain during the years [2003][2004][2005][2006][2007][2008]. Methods The studies in this research project were done between 2003 and 2008. Data were collected by means of questionnaires, interviews and register-based studies. Data from the Social Insurance Institution of Finland regarding GS are also included in this article. Key findings Obligatory GS has been a successful pharmaceutical policy reform in Finland, and it has been quite effectively implemented in practice. GS has generated significant savings in the cost of medicines through substitution and price competition. Finnish patients and physicians have accepted it. GS has also had many anticipated impacts on the parties involved in the pharmaceutical distribution chain. However, some of the anticipated effects, such as medicine availability problems, have not materialized. Conclusions Implementation of pharmaceutical policy reforms should always be evaluated from different perspectives and at the beginning of the reform and several years after it has been introduced.

“…Consequently, it is important to know which prescription medicine-related factors affect patients' choices in order to develop and provide information for patients to support their decision making. Although a large number of studies have examined GS from different perspectives, only a few have explored prescription medicine-related factors that affect patients' choice of prescription medicine [8,9,[18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Reasons for allowing and refusing generic substitution and factors determining the choice of an interchangeable prescription medicine: a survey among pharmacy customers in Finland

Nokelainen

Lämsä

Ahonen

et al. 2020

BMC Health Serv Res

Self Cite

Background: Generic substitution (GS) was introduced in Finland in 2003 and supplemented with a reference price system (RPS) in 2009. Patients play a vital role in the acceptance of GS and the use of less expensive generic medicines. The objective of this study was to explore Finnish pharmacy customers' experience with allowing and refusing GS. Specific aims were to investigate the reasons for (1) allowing and (2) refusing GS and (3) to determine the prescription medicine-related factors influencing the customer's choice of an interchangeable prescription medicine. Methods: A questionnaire survey was conducted in February 2018. Questionnaires were handed out from 18 community pharmacies across Finland to customers ≥18 years who purchased for themselves a prescription medicine included in the RPS. A descriptive approach was used in the analysis using frequencies, the Chi-square test and Fisher's exact test. Results: The final study material consisted of 1043 questionnaires (response rate 40.0%). Of the customers, 47.9% had both allowed and refused GS, 41.2% had only allowed GS and 6.0% had only refused GS. Customers had allowed GS because they wanted to lower their medicine expenses (75.5%), or because the prescribed medicine (30.8%) or medicine they had used before (27.4%) was unavailable at the pharmacy. The main reasons for refusing GS were an insignificant price difference between interchangeable medicines (63.3%) and satisfaction with the medicine used before (60.2%). The main factors influencing customers' choice of an interchangeable prescription medicine were price (81.1%), familiarity (38.4%) and availability (32.8%). Customers who had allowed GS chose the medicine based on price. Customers who had only refused GS appreciated familiarity more than the price of the medicine. Conclusions: GS is a common practice in Finnish community pharmacies. The price of the medicine was the most important factor affecting customers' decision to allow or refuse GS and the choice of an interchangeable prescription medicine. Thus, customers should receive information about medicine prices at the pharmacy in order to help them make their decision. However, individual needs should also be taken into account in counselling because customers regard several factors as important in their choice of an interchangeable medicine.