Generic drug prescriptions following hospital discharge: A prospective study in France

Chu, CH; Rudant, E.; Bonvalet, M.; Agostini, Hélène; Cavalié, Philippe; Bonhomme-Faivre, Laurence; Frenkiel, J.; Taillandier, J; Boissonnas, A; Vittecoq, D.; Wyplosz, Benjamin

doi:10.1016/j.ejim.2011.01.016

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…In countries with restricted access of patients to original patented medicines the objective of generic drug policies can be also defined from an investment perspective: health gain by improved patient access without need for additional health budget [7]. The majority of scientific publications support the cost-saving potential of generic medicines [10][11][12], but empirical evidence related to increased patient access is limited [13].…”

Section: Introductionmentioning

confidence: 99%

Policy objective of generic medicines from the investment perspective: The case of clopidogrel

et al. 2017

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The objective of generic drug policies in most countries is defined from a disinvestment perspective: reduction in expenditures without compromising health outcomes. However, in countries with restricted access of patients to original patented drugs, the objective of generic drug policies can also be defined from an investment perspective: health gain by improved patient access without need for additional health budget. This study examines the investment aspect of generic medicines by analyzing clopidogrel utilization in European countries between 2004 and 2014 using multilevel panel data models. We find that clopidogrel consumption was strongly affected by affordability constraints before the generic entry around 2009, but this effect decayed by 2014. After controlling for other variables, utilization had a substantially larger trend increase in lower-income European countries than in the higher-income ones. Generic entry increased clopidogrel consumption only in lower- and average-income countries but not in the highest-income ones. An earlier generic entry was associated with a larger effect. The case of clopidogrel indicates that the entrance of generics may increase patient access to effective medicines, most notably in lower-income countries, thereby reducing inequalities between European patients. Policymakers should also consider this investment aspect of generic medicines when designing pharmaceutical policies.

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Section: Introductionmentioning

confidence: 99%

Policy objective of generic medicines from the investment perspective: The case of clopidogrel

et al. 2017

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“…Supply-side reforms include pricing reforms such as volume agreements with payback mechanisms for over budget situations and compulsory price cuts, as well as measures to obtain low prices for generics [ 5 - 11 ]. Demand-side measures, collated under the four Es—education, engineering, economics, and enforcement [ 5 ]—include general practitioners’ incentives to prescribe generic drugs [ 12 - 14 ], pharmacists’ use of generics in substitution for originator drugs [ 15 - 18 ], and consumers’ attitudes to generic drugs [ 17 - 20 ]. These measures have resulted in some progress; e.g., there has been an increase in the use of generics in Portugal [ 21 ], generic substitution has been welcomed in Finland [ 17 ], and there are incentives for pharmacists’ to dispense generics in France [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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

Zhang

2013

BMC Health Serv Res

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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.

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“…49 A strategy aimed to increase a systematic spread of generics is to prescribe generic drugs at any hospital discharge. 50 There are some basic facts in favor of generics: i) they have already been used for a long time, therefore they are substantially well known in terms of quality, efficacy and safety; ii) the price reduction defined by law in at least 20% (although currently the price reduction can reach over 60% of the retail price) allows to allocate resources to innovative medicines without giving up long-established treatments; iii) they offer an opportunity for saving money not only to the National Health Service, but also to citizens. Promoting generic prescribing among specialists and generalists may increase opportunities for patients and payers to reduce spending on prescription drugs.…”

Section: Discussionmentioning

confidence: 99%

Generic - equivalent drugs use in internal and general medicine patients: distrust, confusion, lack of certainties or of knowledge? Part 3. Clinical issues

Nardi

Masina²,

Cioni

et al. 2014

Ital J Med

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The practical use of equivalent drugsIn the clinical practice, several aspects associated with the use of equivalent drugs need to be considered (Table 1). Determination of bioequivalence by means of studies in healthy volunteers as a single doseBioequivalence studies are performed on healthy volunteers. It is conventionally accepted that a similar bioavailability found in these people is a solid proof of a similar bioavailability in sick people! This model applied in vivo on healthy volunteers is considered adequate in most instances to detect formulation differences and to allow extrapolation of results to populations for which the reference medicinal product is approved (elderly, children, patients with renal or liver impairment, etc.). Another critical aspect of bioequivalence research is that it is recognized on the basis of studies carried out on a single dose, despite in clinical practice these drugs are administered in repeated doses to chronic patients. 1 In this respect, one might wonder whether single-dose studies on a limited number of healthy volunteers can adequately mirror the use of drugs in real life and whether the same results apply the most common groups of patients?. 2 According to some, in certain cases bioavailability tests need to be carried out on real patients. The question is not so much whether patients are different from volunteers, but rather whether, and when, these differences could cause two products that seem bioequivalent in normals become bioinequivalent in a clinical setting. A literature review aimed to study these factors in real patients has shown that only very few relevant publications are available on this topic. Moreover, involving patients instead of healthy volunteers would invariably increase inter-subject variability and possibly intra-subject variability as well. 3

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Generic drug prescriptions following hospital discharge: A prospective study in France

Cited by 9 publications

References 14 publications

Policy objective of generic medicines from the investment perspective: The case of clopidogrel

Policy objective of generic medicines from the investment perspective: The case of clopidogrel

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

Generic - equivalent drugs use in internal and general medicine patients: distrust, confusion, lack of certainties or of knowledge? Part 3. Clinical issues

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