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Mostafa S, Mohammad MA, Ebrahim J. Policies and Practices Catalyzing the Use of Generic Medicines: A Systematic Search and Review. Ethiop J Health Sci 2021; 31:167-178. [PMID: 34158764 PMCID: PMC8188110 DOI: 10.4314/ejhs.v31i1.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The use of generic medicines instead of branded, is one of the main policies to decrease the expenditures and provide access to affordable and essential medicines in low and middle-income countries. The present study aims to systematically create a comprehensive synthesis of demand-side policies, encouraging the use of generic medicines. Methods The study systematically searched and reviewed the articles in Medline, Scopus, Web of Science, and Embase from 1.1.2000 to 12.5.2019. A total of 6435 records were identified during this period of time (Medline (n=315), Scopus (n=4323), Web of Science (n=71) and Embase (n=1726)). All stages are conducted according to the Preferred Reporting Item for Systematic Reviews and Meta-Analyzed (PRISMA). Results The encouraging policies and practices were classified into four categories from 44 articles analyzed, including; Prescribing, Dispensing, Patients/consumers, and healthcare organizations. Subthemes were also explored in relation to each category as; education, financial incentives, generic substitution, advertising approaches, and enforcement. Conclusion Various policies should be taken into consideration to encourage successful generic medication prescribing, dispensing, and consumption in both supply and demand-side. Economic, political, socio-cultural, technological, legal, and structural factors could as such accelerate the policies' effect. Studying the experience of successful countries can be helpful for policymakers.
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Affiliation(s)
- Shahmoradi Mostafa
- Ph.D. Candidate, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mosadeghrad Ali Mohammad
- Associate Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Jaafaripooyan Ebrahim
- Associate Professor, Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Moorkens E, Vulto AG, Huys I, Dylst P, Godman B, Keuerleber S, Claus B, Dimitrova M, Petrova G, Sović-Brkičić L, Slabý J, Šebesta R, Laius O, Karr A, Beck M, Martikainen JE, Selke GW, Spillane S, McCullagh L, Trifirò G, Vella Bonanno P, Mack A, Fogele A, Viksna A, Władysiuk M, Mota-Filipe H, Meshkov D, Kalaba M, Mencej Bedrač S, Fürst J, Zara C, Skiöld P, Magnússon E, Simoens S. Policies for biosimilar uptake in Europe: An overview. PLoS One 2017; 12:e0190147. [PMID: 29284064 PMCID: PMC5746224 DOI: 10.1371/journal.pone.0190147] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 12/09/2017] [Indexed: 12/04/2022] Open
Abstract
Background Across European countries, differences exist in biosimilar policies, leading to variations in uptake of biosimilars and divergences in savings all over Europe. Objectives The aim of this article is to provide an overview of different initiatives and policies that may influence the uptake of biosimilars in different European countries. Recommendations will be formulated on how to create sustainable uptake. Methods An overview of policies on biosimilars was obtained via a questionnaire, supplemented with relevant articles. Topics were organized in five themes: availability, pricing, reimbursement, demand-side policies, and recommendations to enhance uptake. Results In all countries studied, biological medicines are available. Restrictions are mainly dependent on local organization of the healthcare system. Countries are willing to include biosimilars for reimbursement, but for commercial reasons they are not always marketed. In two thirds of countries, originator and biosimilar products may be subjected to internal reference pricing systems. Few countries have implemented specific incentives targeting physicians. Several countries are implementing pharmacist substitution; however, the scope and rules governing such substitution tend to vary between these countries. Reported educational policies tend to target primarily physicians, whereas fewer initiatives were reported for patients. Recommendations as proposed by the different country experts ranged from the need for information and communication on biosimilars to competitive pricing, more support for switching and guidance on substitution. Conclusions Most countries have put in place specific supply-side policies for promoting access to biosimilars. To supplement these measures, we propose that investments should be made to clearly communicate on biosimilars and educate stakeholders. Especially physicians need to be informed on the entry and use of biosimilars in order to create trust. When physicians are well-informed on the treatment options, further incentives should be offered to prescribe biosimilars. Gainsharing can be used as an incentive to prescribe, dispense or use biosimilars. This approach, in combination with binding quota, may support a sustainable biosimilar market.
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Affiliation(s)
- Evelien Moorkens
- KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
- * E-mail:
| | - Arnold G. Vulto
- Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Isabelle Huys
- KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
| | - Pieter Dylst
- KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
- Medicines for Europe, Brussels, Belgium
| | - Brian Godman
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Strathclyde Institute for Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Simon Keuerleber
- Main Association of Austrian Social Security Institutions, Vienna, Austria
| | - Barbara Claus
- Faculty of pharmaceutical sciences, Ghent University, Ghent, Belgium
| | - Maria Dimitrova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | | | - Juraj Slabý
- State Institute for Drug Control, Prague, Czech Republic
| | - Robin Šebesta
- State Institute for Drug Control, Brno, Czech Republic
| | - Ott Laius
- State Agency of Medicines, Tartu, Estonia
- Department of Traumatology and Orthopedics, University of Tartu, Tartu, Estonia
| | - Allan Karr
- Karr Consultancy Ltd, Hertfordshire, United Kingdom
| | - Morgane Beck
- OMEDIT Alsace, Agence Régionale de Santé du Grand Est, Strasbourg, France
| | | | | | - Susan Spillane
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
- National Centre for Pharmacoeconomics, St James's Hospital, Dublin, Ireland
| | - Laura McCullagh
- Department of Pharmacology and Therapeutics, Trinity College Dublin, Dublin, Ireland
- National Centre for Pharmacoeconomics, St James's Hospital, Dublin, Ireland
| | - Gianluca Trifirò
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Patricia Vella Bonanno
- Strathclyde Institute for Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Asbjørn Mack
- Division Pharmaceuticals, Norwegian Hospital Procurement Trust, Oslo, Norway
| | - Antra Fogele
- Department of Medicines and Medical Devices, The National Health Service, Riga, Latvia
| | - Anita Viksna
- Department of Medicines and Medical Devices, The National Health Service, Riga, Latvia
| | | | | | - Dmitry Meshkov
- Semashko National Research Institute for Public Health, Moscow, Russia
| | | | - Simona Mencej Bedrač
- Agency for Medicinal Products and Medical Devices of the Republic of Slovenia, Ljubljana, Slovenia
| | - Jurij Fürst
- Health Insurance Institute, Ljubljana, Slovenia
| | - Corrine Zara
- Barcelona Health Region, Catalan Health Service, Barcelona, Spain
| | | | | | - Steven Simoens
- KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
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Sicras-Mainar A, Rejas-Gutiérrez J, Pérez-Páramo M, Navarro-Artieda R. Cost of treatment of peripheral neuropathic pain with pregabalin or gabapentin in routine clinical practice: impact of their loss of exclusivity. J Eval Clin Pract 2017; 23:402-412. [PMID: 27671223 PMCID: PMC5396294 DOI: 10.1111/jep.12634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/01/2016] [Accepted: 08/01/2016] [Indexed: 12/13/2022]
Abstract
To analyze the effect of loss of exclusivity of data on the cost of treatment of peripheral neuropathic pain (PNP) with pregabalin or gabapentin in routine clinical practice. A retrospective observational study, with electronic medical records for patients enrolled at primary care centers managed by the health care provider Badalona Serveis Assistencials, who initiated treatment of PNP with pregabalin or gabapentin. The analysis used drugs and resources prices for year 2015. The 1163 electronic medical records (pregabalin; N = 764, gabapentin; N = 399) for patients (62.2% women) with a mean (standard deviation) age of 59.2 (14.7) years were analyzed. Treatment duration was slightly shorter with pregabalin than with gabapentin (5.2 vs 5.5 months; P = 0.124), with mean doses of 227.4 (178.6) mg and 900.0 (443.4) mg, respectively. The average study drug cost per patient was higher for pregabalin than for gabapentin; €214.6 (206.3) vs €157.4 (181.9), P < 0.001, although the cost of concomitant analgesic medication was lower; €176.5 (271.8) vs €306.7 (529.2), P < 0.001. The adjusted average total cost per patient was lower in those treated with pregabalin than in those treated with gabapentin; €2,413 (2119-2708) vs €3201 (2806-3.597); P = 0.002, owing to significantly lower health care costs; €1307 (1247-1367) vs €1538 (1458-1618), P < 0.001, and also non-health care costs; €1106 (819-1393) vs €1663 (1279-2048), P = 0.023, that was caused by a significantly lower use of concomitant medication, fewer medical visits to primary care, and fewer days of sick leave. After loss of exclusivity of both drugs, pregabalin continued to show lower health care and non-health care costs than gabapentin in the treatment of PNP in routine clinical practice.
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Affiliation(s)
| | - Javier Rejas-Gutiérrez
- Health Economics and Outcomes Research Department, Pfizer SLU, Alcobendas, Madrid, Spain
| | | | - Ruth Navarro-Artieda
- Medical Documentation Department, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain
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Dylst P, Vulto A, Simoens S. Societal value of generic medicines beyond cost-saving through reduced prices. Expert Rev Pharmacoecon Outcomes Res 2015; 15:701-11. [PMID: 25695926 DOI: 10.1586/14737167.2015.1017565] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This paper aims to provide an overview of the added societal value of generic medicines beyond their cost-saving potential through reduced prices. In addition, an observational case study will document the impact of generic entry on access to pharmacotherapy in The Netherlands and an illustrative exercise was carried out to highlight the budget impact of generic entry. METHODS A narrative literature review was carried out to explore the impact of generic medicines on access to pharmacotherapy, innovation and medication adherence. Data from the Medicines and Medical Devices Information Project database in The Netherlands were used for the case study in which the impact of generic medicine entrance on the budget and the number of users was calculated as an illustrative exercise. RESULTS Generic medicines have an additional societal value beyond their cost-saving potential through reduced prices. Generic medicines increase access to pharmacotherapy, provide a stimulus for innovation by both originator companies and generic companies and, under the right circumstances, have a positive impact on medication adherence. CONCLUSION Generic medicines offer more to society than just their cost-saving potential through reduced prices. As such, governments must not focus only on the prices of generic medicines as this will threaten their long-term sustainability. Governments must therefore act appropriately and implement a coherent set of policies to increase the use of generic medicines.
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Affiliation(s)
- Pieter Dylst
- KU Leuven Department of Pharmaceutical and Pharmacological Sciences, Leuven, Belgium
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