Elements to promote competition characterise the Dutch pharmaceutical system. An example of such a competitive approach is the ‘generic preference policy’ allowing social health insurance institutions to limit reimbursement to lower priced labels of off-patent active ingredients. Under the ‘generic preference policy’, the insurance institutions tender for specific active ingredients where generic alternatives exist and they reimburse the medicine offering the lowest price.

Instruments to promote generics have been in place for a long time and are generally accepted. Generic substitution was connected with a financial incentive for pharmacists for many years, i.e. they could keep one third of their savings due to generic substitution, which was abolished in 2004. Nonetheless, the substitution rates have not decreased.

International non-proprietary name (INN) prescribing is indicative, but supported by prescribing software which automatically changes the brand name to the INN.

Acknowledgement

This article is published with permission of the Gesundheit Österreich GmbH (GÖG)/Austrian Health Institute.

We gratefully acknowledge the support from Dr Sabine Vogler of Gesundheit Österreich GmbH / Österreichisches Bundesinstitut für Gesundheitswesen (GÖG/ÖBIG – Austrian Health Institute) to GaBI Online.

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Reference

Vogler S, Schmickl B. Rational use of medicines in Europe. Gesundheit Österreich GmbH / Österreichisches Bundesinstitut für Gesundheitswesen (GÖG/ÖBIG). February 2010.