Does NICE influence the adoption and uptake of generics in the UK?

Abstract

The aim of this paper is to examine generic competition in the UK, with a special focus on the role of Health Technology Assessment (HTA) on generic market entry and diffusion. In the UK, where no direct price regulation on pharmaceuticals exists, HTA has a leading role for recommending the use of medicines providing a non-regulatory aspect that may influence the dynamics in the generic market. The paper focuses on the role of Technology Appraisals issued by the National Institute for Health and Care Excellence (NICE). We follow a two-step approach. First, we examine the probability of generic entry. Second, conditional on generic entry, we examine the determinants of generic market share. We use data from IQVIA British Pharmaceutical Index (BPI) for the primary care market for 60 products that lost patent between 2003 and 2012. Our results suggest that market size remains one of the main drivers of generic entry. After controlling for market size, intermolecular substitution and difficulty of manufacturing increase the likelihood of generic entry. After generic entry, our estimates suggest that generic market share is highly state dependent. Our findings also suggest that while NICE recommendations do influence generic uptake, there is only marginal evidence they affect generic entry.

International comparisons expose the UK’s poor performance on health

“…And while the proportion of the population with supplementary private health insurance is still lower than in comparator countries, uptake is growing faster in the UK than in the rest of the G7 10. Similarly, the UK’s comparative efficiency measured in administrative spending and generic substitution, can at least be partly attributed to past efforts and reforms, such as the single payer financing model11 and creation of the National Institute for Health and Care Excellence 12. Meanwhile, other important efficiencies, such as the productivity of the workforce, are threatened by low levels of staff and beds 89…”