Patient access schemes (PAS) have become an integral part of the UK pharmaceutical environment. This article investigates the historical role PAS have played in regard to health technology appraisals (HTAs), how the mechanism interacts with other features of the UK funding environment, such as the Cancer Drugs Fund (CDF), and the PAS strategies employed by pharmaceutical companies to optimise funding recommendations. It also takes a forward look towards any role PAS might have in a value-based pricing system, which is potentially facing the UK from 2014. PAS have shifted from outcome-based schemes to financially-based discounts. It is clear that as PAS have become more integral to the UK HTA environment, an acceptance of confidentiality and a requirement to prove that PAS reduce uncertainty to payers are two major developments. The article also highlights how the CDF may act as a potential disincentive for manufacturers to engage with PAS and provide the NHS with discounts to achieve cost-effectiveness. The key going forward is stability; providing a framework which allows payers to determine value, but permits pharmaceutical companies to exist in a credible pricing operating environment.

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ITC is generally accepted as a technique that allows demonstration of noninferiority to a comparator provided the chosen methodology and underlying assumptions are clear and justified. However, HTA agencies are more likely to closely scrutinize submitted data and evaluate statistical significance of results when superiority is claimed. In addition, the HTA agencies in scope tended to be cautious and only accept ITC data as support for similarity of treatments.

With global healthcare budgets increasingly under pressure due to escalating costs, the spend on pharmaceuticals is a prime target for healthcare planners as it is the second largest budget item after staffing expenditure. Against this financial pressure, payers are, understandably, looking at any avenue to save costs and a method that looks increasingly attractive to healthcare planners is boosting prescribing of alternatives to branded medicines via generics and biosimilars. Although generic substitution has largely been accepted as desirable, the prescribing of biosimilars remains contentious. This article looks at the various issues and policies affecting the uptake of non-branded medicines in the UK and across the globe, and highlights the most important issues associated with the topic to assist policy-making going forward. The UK has managed to achieve a high level of generic prescribing without implementing a policy of mandatory prescribing; and the key to the success of this policy is physician advocacy, a concept that must form the bedrock of any policy seeking to expand biosimilar market penetration, both in this country and abroad.

Objectives: In recent years, the generic drug has been the subject of public debate in Greece. The use of generic drugs effectively reduces public pharmaceutical expenditure and improves the sustainability of the social security system. The aim of the present study was to evaluate the knowledge perceptions and attitudes of final year pharmacy students towards generic drugs. MethOds: Final year pharmacy students of three Universities in Greece were invited to fill out an electronic questionnaire relating to respondents use, perceptions and knowledge of generic drugs. 40 closed-ended, multiple choice and cumulative scoring scale questions were included. Descriptive statistics were used to analyse study findings using the Microsoft Excel program. Results: 173 students (36 male) took part in the survey. Analysis of the resultant data indicated that 89% of the pharmacy students were aware that generic products are comparable in dosage form, strength and route of administration to originator medicines, but may contain different excipients (71%) and may be sold for significantly lower prices (78%). Despite, the generally positive attitude towards generic drugs of > 90% of pharmacy students, a significant percentage did not have a clear opinion of their safety (46%) and efficacy (55%) compared to brand-name products. Almost all the students considered it important that (1) the National Organization of Medicine (EOF) be responsible for establishing bioequivalence of generic medicines and (2) health professionals be better educated about generics so as to better educate patients. cOnclusiOns: The Greek government has already taken several steps toward increasing the use of generics and improving their integration into the local healthcare system. In keeping with the results of the survey, students, patients and health professionals need to be better informed about generics. Greek pharmaceutical industries, the state and health professionals should take measures to sustain the assimilation of generics into the Greek market.Objectives: In the European health-care-systems expenditures of medical goods including pharmaceuticals account for 12% to 36% of total health-care budgets. Obviously, they are a major concern for decision-makers. Pharmaceutical prices significantly differ across countries, due to different cost-containment measures, national attitude of accessibility and affordability. Unfortunately, there is no generally accepted methodology on how to conduct price comparisons. In 2003, the first WHO/HAI medicine price manual has been published, but the majority of price comparisons assessing price levels still has violated standard methods of index number theory and is based on small samples (from 5 products to entire market). The aim of the present analysis was to draw a comprehensive picture of the pharmaceutical price levels in Europe. MethOds: The study analyzed drug prices of the reimbursed retail market of all countries of the European Union except Denmark, plus Switzerland. It is stipulated that all reimbursed m...