Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilization: changes seen and global implications

Godman, Brian; Shrank, William H.; Andersen, Morten; Berg, Christian; Bishop, Iain; Burkhardt, Thomas; Garuolienė, Kristina; Herholz, Harald; Joppi, Roberta; Kalaba, Marija; Laius, Ott; McGinn, Diane; Samaluk, Vita; Sermet, Catherine; Schwabe, Ulrich; Teixeira, Inês; Tilson, Lesley; Tulunay, F. Cankat; Vlahović‐Palčevski, Vera; Wendykowska, Kamila; Wettermark, Björn; Zara, Corinne; Gustafsson, Lars L.

doi:10.1586/erp.10.72

Cited by 145 publications

(271 citation statements)

References 55 publications

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“…These are in addition to compulsory price cuts for both originators and generics instigated among some European countries as they struggle to contain rising pharmaceutical expenditure [1,3,5,8,9].…”

Section: Pr Icin G Policies To H Elp Low Er Th E Pr Ice Of Gen Er Icsmentioning

confidence: 99%

“…However, the general trend is for countries to introduce additional measures to lower their generics prices to maximise savings with countries continuing to learn from each other [3,5,8], introducing initiatives highlighted in Table 1. For instance, high volume generics in Sweden and UK are priced at between 3-13% of pre-patent loss prices through a variety of market force measures, some of which are highlighted in Table 2 [3,7,14,21].…”

Section: Pr Icin G Policies To H Elp Low Er Th E Pr Ice Of Gen Er Icsmentioning

confidence: 99%

“…As a result, these measures help fund increased drug volumes and new drugs without having to raise taxes or health insurance premiums. However, recent research has shown that among the proton pump inhibitors (PPIs), 3-hydroxy-3-methil-gluteryl-CoA reductase inhibitors (statins) and renin-angiotensin products, there is considerable variation in the prescribing of generics within a class or related classes once generics become available in a class [5,8,15,26,27]. Consequently, there are appreciable opportunities for countries to further enhance their prescribing of generics and lower their prescribing costs through learning from each other.…”

Section: Deman D-side Measur Es To En H An Ce Th E Pr Escr Ibin G Of mentioning

confidence: 99%

“…Examples include increased prescribing of esomeprazole with decreased prescribing of omeprazole as a % of total PPI utilisation, which has been seen in France, Ireland, and Portugal [5,8]. The reverse was seen in countries that have instigated multiple and intensive demand-side measures such as Spain (Catalonia), Sweden, and UK.…”

Section: Deman D-side Measur Es To En H An Ce Th E Pr Escr Ibin G Of mentioning

confidence: 99%

See 3 more Smart Citations

European payer initiatives to reduce prescribing costs through use of generics

Godman¹,

Wettermark²,

Bishop³

et al. 2012

GaBI J

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Section: Pr Icin G Policies To H Elp Low Er Th E Pr Ice Of Gen Er Icsmentioning

confidence: 99%

Section: Pr Icin G Policies To H Elp Low Er Th E Pr Ice Of Gen Er Icsmentioning

confidence: 99%

Section: Deman D-side Measur Es To En H An Ce Th E Pr Escr Ibin G Of mentioning

confidence: 99%

Section: Deman D-side Measur Es To En H An Ce Th E Pr Escr Ibin G Of mentioning

confidence: 99%

See 2 more Smart Citations

European payer initiatives to reduce prescribing costs through use of generics

Godman¹,

Wettermark²,

Bishop³

et al. 2012

GaBI J

Self Cite

View full text Add to dashboard Cite

“…Healthcare professionals are concerned about switching between asthma drugs because it may negatively affect disease control through low adherence, and incorrect use of aerosol delivery device types [3,8]. In literature, there is evidence that switching has a negative impact on adherence and disease control through changes in color, size, and packaging [9][10][11][12]. Data from a questionnaire study showed that patients who switched asthma medication, more often experienced difficulties using the device (23% vs. 13%), were less likely to be adherent (55% vs. 68%) and were less likely to report being asthma controlled (69% vs. 83%) compared to patients who did not switch [13].…”

Section: Introductionmentioning

confidence: 99%

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study

et al. 2017

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Background: The expiration of patents of brand inhalation medications and the ongoing pressure on healthcare budgets resulted in a growing market for generics. Aim: To study the use of brand and generic inhalation medication and the frequency of switching between brand and generic and between devices. In addition, we investigated whether switching affected adherence. Methods: From dispensing data from the Dutch PHARMO Database Network a cohort aged ࣙ 5 years, using ࣙ 1 year of inhalation medication between 2003 and 2012 was selected. Switching was defined as changing from brand to generic or vice versa. In addition, we studied change in aerosol delivery device type (e.g., DPI, pMDI, and nebulizers). Adherence was calculated using the medication possession ratio (MPR). Results: The total cohort comprised 70,053 patients with 1,604,488 dispensations. Per calendar year, 5% switched between brand and generic inhalation medication and 5% switched between devices. Median MPRs over the first 12 months ranged between 33 and 55%. Median MPR over the total period was lower after switch from brand to generic and vice versa for formoterol (44.5 vs. 42.1 and 63.5 vs. 53.8) and beclomethasone (93.8 vs. 59.8 and 81.3 vs. 55.9). Conclusion: Per year, switching between brand and generic inhalation medication was limited to 5% of the patients, switching between device types was observed in 5% as well. Adherence to both generic and brand inhalation medication was low. Effect of switching on adherence was contradictory; depending on time period, medication and type, and direction of switching. Further research on reasons for switching and potential impact on clinical outcomes is warranted.

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The Effect of Financial and Educational Incentives on Rational Prescribing. A State-Space Approach

et al. 2014

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In 2005, a Dutch health insurer introduced a financial incentive directed to general practitioners to promote rational prescribing of statins and proton pump inhibitors (PPIs). Concomitantly, a regional institution that develops pharmacotherapeutic guidelines implemented two educational interventions also aiming at promoting rational statin and PPI prescribing. Utilizing a prescription database, we estimated the effect of the interventions on drug utilization and cost of statins and PPIs over time. We measured the effect of the interventions within an implementation and a control region. The implementation region included prescriptions from the province of Groningen where the educational intervention was implemented and where the health insurer is most active. The control region comprised all other provinces covered by the database. We modelled the effect of the intervention using a state-space approach. Significant differences in prescribing and cost patterns between regions were observed for statins and PPIs. These differences however were mostly related to the concurrent interventions of Proeftuin Farmacie Groningen. We found no evidence indicating a significant effect of the rational prescribing intervention on the prescription patterns of statins and PPIs. Our estimates on the economic impact of the Proeftuin Farmacie Groningen interventions indicate that educational activities as such can achieve significant cost savings.

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Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilization: changes seen and global implications

Cited by 145 publications

References 55 publications

European payer initiatives to reduce prescribing costs through use of generics

European payer initiatives to reduce prescribing costs through use of generics

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study

The Effect of Financial and Educational Incentives on Rational Prescribing. A State-Space Approach

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