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Switching between generics of anti-epileptic drugs

Two different generic versions of anti-epilepsy medicine lamotrigine have been shown to be bioequivalent in patients with epilepsy and to not cause any differences in seizure frequency or adverse events, according to a study published in the February 2016 online edition of The Lancet Neurology.

Cost-effectiveness analysis and incentivizing innovation

In the paper by Santiago Moreno and Joshua Ray, the controversial role that conventional cost-effectiveness analysis (CEA) plays in incentivizing innovation is revealed [1]. Detractors criticize its use for pricing purposes because it disregards the value of innovation brought by new drugs, while supporters argue that it is already accounted for. The objective of the paper is to identify the limitations of the conventional CEA approach and to propose an alternative that offers a more realistic estimate of the true value of innovation.

Perceptions of the value of generics in Brazil

Generics were first approved in Brazil in 1999. Substitution of generics and reference drugs can occur at the time of purchase and upon patients’ request, and, in the public healthcare system, physicians must prescribe drugs by their Brazilian Common Denomination (Denominação Comum Brasileira – DCB). However, despite legislation that supports their prescription, generics still have a small market share, representing only 27.3% of all drug units sold in Brazil in January 2014. A potential reason for the low penetration of generics into the Brazilian market is a negative perception of the value of generics.

Perceptions of the substitution of generics

Pharmacists are mostly positive about the substitution of generics for brand-name drugs, according to a study analysing negative perceptions about generics, carried out by researchers from New Zealand and the US [1].

Perceptions of the safety and side effects of generics

A quarter of doctors believe that generics are less safe and cause more side effects than brand-name drugs, according to a study carried out by researchers from New Zealand and the US [1].

Perceptions of the effectiveness and quality of generics

More than a quarter of doctors and the general public believe that generics are less effective and of poorer quality than brand-name drugs, according to a study carried out by researchers from New Zealand and the US [1].

Generics perceptions in patients, pharmacists and doctors

A significant proportion of the general public, pharmacists and doctors have negative perceptions about generics, according to a study carried out by researchers from New Zealand and the US [1].

Substitution of generic antiepileptic drugs

Despite the availability of generic antiepileptic drugs (AEDs), patients and neurologists still hesitate to make a switch due to several reasons.

Impact of South Korea’s new drug–pricing policy on market competition

In April 2012, the Korean Government implemented a new policy to try and make its multiple sourced (off-patent) market more competitive. Their objective was to lower the price of generics through increased competition. The government in this way also aimed to reduce the costs for both patients [who have typically a 30% co-payment in ambulatory care (20% in hospitals)] and the National Health Insurance. The core of the policy was to establish the same maximum reimbursement price, i.e. the same ceiling price, for both the originator (brand-name) and the generic drug. This was expected to make the market more competitive, with generics manufacturers competing with each other to gain market share by lowering their prices. However, other professionals argued that this policy would still favour originators, given the general belief that an originator medicine, which is often from an international pharmaceutical company, would be better quality.

Costs and prices of entecavir to treat Hepatitis B

In an analysis of the costs and target prices of Hepatitis B treatment entecavir, author Andrew Hill from Liverpool University, UK and colleagues from Imperial College London, UK and Howard University, Washington DC, USA investigated how use of generics is affecting the cost of Hepatitis B treatment around the world [1].

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