Demand-side policies to encourage the use of generic medicines: an overview

Abstract

Demand-side policies to encourage the use of generic medicines are important to increase their use. A plethora of different demand-side policies has already been initiated by European governments, thereby targeting physicians, pharmacists and patients. This review aims to give an overview of the different demand-side policies which governments have at their disposal and to evaluate their impact on the use of generic medicines. Positive knowledge and perceptions of physicians, pharmacists and patients of generic medicines are necessary prerequisites to increase the use of generic medicines and governments should initiate policies to achieve this. These policies should be combined with policies to increase their financial responsibility to the healthcare system and policies to facilitate the prescribing of generic medicines.

A Case Study in Generic Drug Use: Should There Be Risk Adjustment in Incentive Payments for the Use of Generic Medications?

“…10 Payers commonly offer financial incentives to providers for achieving benchmark rates of generic drug use. 11,12 Providers and payers should understand the extent to which patient case mix affects the ability to prescribe generic medications. For example, if an IPA sees a high volume of patients with insulindependent type 2 diabetes mellitus, they will be forced, due to the nature of the disease state, to prescribe more brand-name products for which therapeutic alternatives do not exist (i.e., glucometers, insulin, glucose testing strips, glucose testing lancets, insulin syringes) compared with an IPA that has a low volume of insulin-dependent type 2 diabetic patients.…”

How Can Pricing and Reimbursement Policies Improve Affordable Access to Medicines? Lessons Learned from European Countries

“…European countries have increasingly been implementing generic policies [93,94] (see Table 1 for definitions of generic policies listed below). They are particularly aimed at ensuring swift market entry of high-quality generics, bring down the prices of multi-source products (off-patent originator medicines and generic medicines) and improve generics' acceptance and uptake of lower-priced medicines.…”

“…Overall, competitive pricing policies, including tendering, as used in some Nordic European countries, appear to be more successful than other, more regulated generic policies in reducing the price levels of generics as well as of competitor originators as well as increasing generics' uptake, in particular if coupled them with demandside measures [96,101]. The quality of generics is ensured in the EU Member States and neighbouring European countries, but lack of trust into the quality of generics by patients and even health professionals is still an issue [94,102,103]. It has been noted, e.g.…”

How do regional sickness funds encourage more rational use of medicines, including the increase of generic uptake? A case study from Austria

“…The second important target group is the insured party who is typically addressed through information activities (journal, information events). Few measures, if any, targeted pharmacists, despite evidence showing the important role of pharmacists in enhancing more rational use of medicines in several countries [19,24,[62][63][64]. The reason why pharmacists in Austria are not considered a relevant target group by sickness funds may be because pharmacists cannot play an important role in generics policies, as Austria is the only country in the EU where neither generics substitution nor INN prescribing are permitted nor is a reference price system in place [23].…”

“…Generic medicines help reduce the costs incurred by public payers [6,21] and are, in accordance with the WHO Nairobi declaration [1], a way of supporting rational use of medicines. It seems, however, that generics policies are not fully exploited in some European countries [22][23][24][25]. Policies to promote generics uptake, which is defi ned as the increase in the use of generics compared with the originator or patent medicines within a substitutable class, include the promotion of generics substitution at all levels of the health system, and the promotion of generics acceptance by professionals, patients, and the general community [26][27][28].…”