A price and use comparison of generic versus originator cardiovascular medicines: a hospital study in Chongqing, China

Abstract

BackgroundDeveloped countries use generic competition to contain pharmaceutical expenditure. China, as a developing and transitional country, has not yet deemed an increase in the use of generic products as important; otherwise, much effort has been made to decrease the drug prices. This paper aims to explore dynamically the price and use comparison of generic and originator drugs in China, and estimate the potential savings of patients from switching originator drugs to generics.MethodsA typical hospital in Chongqing, China, was selected to examine the price and use comparisons of 12 cardiovascular drugs from 2006 to 2011.ResultsThe market share of the 12 generic medicines studied in this paper was 34.37% for volume and 31.33% for value in the second half of 2011. The price ratio of generic to originator drugs was between 0.34 and 0.98, and the volume price index of originators to generics was 1.63. The potential savings of patients from switching originator drugs to generics is 65%.ConclusionThe market share of the generics was lowering and the weighted mean price kept increasing in face of the strict price control. Under the background of hospitals both prescribing and dispensing medicines, China’s comprehensive healthcare policy makers should take measures from supply and demand sides to promote the consumption of generic medicines.

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

“…Multifaceted demandside measures enacted to achieve these savings include high International non-proprietary name (INN) prescribing, formularies, prescribing guidance, continuous medical education, quality circles, strengthening of drug and therapeutic committees (DTCs), prescribing targets, financial incentives and prescribing restrictions (2,12,13,18,19,21,(24)(25)(26). Considerable savings can also be achieved in low-and middle-income countries from switching from use of originators to use of the lowest-priced equivalent generic drugs (27)(28)(29).…”

“…Expenditure has increased more rapidly in recent years reaching US$350 per capita in 2011 (33). In 2010, pharmaceutical revenues for Chinese public hospitals was 405.39 billion CNY (approximately US$ 62.4 billion), 46% of total healthcare expenditure (29,41), with out-of-pocket payments accounting for 36% of total healthcare expenditure (35).…”

“…These measures have principally been aimed at trying to control pharmaceutical expenditure in hospitals, because more than 80% of total pharmaceutical consumption in China is currently occurring in hospitals (29,35,37,42). For state-priced products, the National Development and Reform Commission (NDRC) sets maximum retail prices (price cap) including mark-ups; for province-or municipality-priced products, the price management department determines the retail prices.…”

“…China has also seen considerable increases in pharmaceutical expenditure in recent years which has been growing at over 16% per annum during the past decade (29)(30)(31)(32). This has continued into the current decade (33).…”

Initiatives to increase the prescribing of low cost generics; the case of Scotland in the international context

“…However, there has been low use of generics versus originators among hospitals in China, where most medicines are dispensed, when compared to a number of European countries (172)(173)(174), e.g. generic statins accounted for only 9% to 10 % of total statins in recent years in hospitals in China international context (175).…”