Generic substitution in Finland: lessons learned during 2003-2008

Abstract

Objectives Obligatory generic substitution (GS) was introduced in Finland in 2003 with the aim of containing medicine costs. In this article The materialized impacts of GS are compared with the impacts that were anticipated before GS was introduced. The implementation of GS in Finland is described from the perspectives of generated savings, patients, physicians and the pharmaceutical distribution chain during the years [2003][2004][2005][2006][2007][2008]. Methods The studies in this research project were done between 2003 and 2008. Data were collected by means of questionnaires, interviews and register-based studies. Data from the Social Insurance Institution of Finland regarding GS are also included in this article. Key findings Obligatory GS has been a successful pharmaceutical policy reform in Finland, and it has been quite effectively implemented in practice. GS has generated significant savings in the cost of medicines through substitution and price competition. Finnish patients and physicians have accepted it. GS has also had many anticipated impacts on the parties involved in the pharmaceutical distribution chain. However, some of the anticipated effects, such as medicine availability problems, have not materialized. Conclusions Implementation of pharmaceutical policy reforms should always be evaluated from different perspectives and at the beginning of the reform and several years after it has been introduced.

Medicine shortages – A study of community pharmacies in Finland

“…This finding is in line with an earlier Finnish study dealing with GS [28]. Our result meant that in most cases the customer received the medicine and in only 12 cases the customer was left with no suitable medicine.…”

“…Generic substitution (GS) and a reference price system (RPS) are in use in Finland [27,28]. According to the Medicine Act 80/2003, pharmacists are obligated to substitute the prescribed product with the cheapest or close to the cheapest interchangeable product if the price of the product is higher than the reference price.…”

Reasons for allowing and refusing generic substitution and factors determining the choice of an interchangeable prescription medicine: a survey among pharmacy customers in Finland

“…The results indicate that GS is a common practice in Finnish community pharmacies. According to studies conducted in the early stage of GS in Finland, GS represented a Some of the respondents did not report their gender, age, area of residence, education or use of prescription medicines significant pharmaceutical policy reform and had been implemented effectively in practice [38]. Finns look favourably on the opportunity to substitute their medicines and they consider less expensive GM effective and safe [5,7].…”

Tendering for off-patent outpatient medicines: lessons learned from experiences in Belgium, Denmark and the Netherlands

“…lower co‐payments for generics, a reference price system in which reimbursement for identical or therapeutically similar medicines is capped) . European countries have been applying a mix of these measures to enhance generic uptake . Some of these instruments apply not only to generics but also to biosimilar medicines, parallel imported medicines or simply ‘cheap’ medicines such as in Belgium …”

“…[2,14,15] European countries have been applying a mix of these measures to enhance generic uptake. [1,[14][15][16][17][18] Some of these instruments apply not only to generics but also to biosimilar medicines, parallel imported medicines or simply 'cheap' medicines such as in Belgium. [16] With regard to pricing, several European countries regulate the prices of generic and further off-patent medicines through the so-called generic price link policy.…”