Generics/Research

Impact of measures to encourage generics prescribing in Scotland

Since 2000, measures have been introduced in Scotland in order to encourage use of generic rather than brand-name proton pump inhibitors (PPIs) and statins [1]. The impact of these measures on the prescribing practices in Scotland has been positive. Generics use has increased, and costs for the Scottish government have decreased.

Prescribing of generic PPIs and statins in Scotland

In Scotland, a series of measures have been introduced since 2000 in order to encourage use of generic rather than brand-name proton pump inhibitors (PPIs) and statins [1]. Some of the measures introduced include:

Data publication may address generics misperceptions

Wider publication of bioequivalence, safety, or efficacy data to demonstrate the effectiveness of generic drug compounds may help to nullify the last remaining anti-generics argument: that generics do not achieve the same therapeutic standards as the original branded drug.

Factors important for generics substitution in Finland

What factors do patients take into account when deciding to accept or reject generics substitution? This is the question asked in a recent research article [1].

Generics market to experience strong growth in 2010–2017

The global market for generic drugs will experience strong growth in the coming years due to patent expiries of blockbuster drugs worth US$150 billion between 2010 and 2017. Cost containment strategies being implemented by governments and healthcare service providers are also given credit for shifting sales towards cheaper generics.

Translational research to uncover new uses for generics

On the surface, generic compounds and translational medicines could not appear more different. However, in April 2011, the US National Institutes of Health (NIH) met with academic, governmental, and industry R & D experts to discuss whether translational methods could help to rescue and re-position certain generics [1].

Generics saved US$931 billion over last 10 years

On 21 September 2011, the US Generic Pharmaceutical Association (GPhA) released the results of an independent analysis showing that the use of generic drugs in the US has saved patients and the healthcare system US$931 billion between 2001 and 2010.

Generic atorvastatin may be better than Crestor

AstraZeneca’s leading cholesterol drug Crestor (rosuvastatin) failed to show a statistically significant benefit over Pfizer’s Lipitor (atorvastatin), according to results of a phase IIIb trial. The results could prove to be good news for generics manufacturers, boosting sales of generic atorvastatin, soon to compete with Crestor.

Tendering for medicines in ambulatory care

Tendering is a mechanism whereby a purchaser buys medicines from the pharmaceutical manufacturer that offers the best bid [1]. Whereas tendering is widely used in the hospital sector, it is only recently being rolled out in ambulatory care in an increasing number of countries with a view to constraining pharmaceutical expenditure. Denmark, Germany and The Netherlands are the countries that have taken up the idea most readily. However, the success of this strategy is not yet clear compared to other European generic medicines pricing policies.

Integrated prescriber dispensing can slow generic growth

Countries such as China, Japan and Taiwan which have public health insurance systems, and which allow physicians to both prescribe and dispense drugs themselves, are the most resistant to generics competition, according to a study by two Taiwanese health economists from the National Cheng-Kung University and Academia Sinica, Taipei, Taiwan [1].

Does switching to generic anti-epileptic drugs lead to loss of seizure control

Patients with epilepsy may have a higher risk of seizures if they switch from their brand-name medication to generic anti-epileptic drugs (AEDs). This is the message often heard from clinicians when expressing their concern over generic versions of narrow therapeutic index (NTI) drugs, one class of which is those used to manage the symptoms of epilepsy.

Switching from a brand-name antiepileptic drug to a generic is not associated with a higher risk of seizures

A report in Clinical Pharmacology and Therapeutics provides further evidence that patients with epilepsy do not have a higher risk of seizures if they switch from their brand-name anti-epileptic drugs (AEDs) to the generic version [1].

How successful is the reference pricing system in Belgium

The main aim of a reference pricing system (RPS) is to provide generic medicines at the lowest cost to the state and individuals. This article explains how RPSs work and asks how the Belgian system might be improved to better fulfil its main objective.

Benefits of generics called into question

The benefits associated with generic prescription drugs have been called into question in an article published in the British Medical Journal (BMJ) [1].

Epilepsy: medical concerns of prescribing generics

Generic economics

Generic medications are generally cheaper than their branded product counterparts and so prescribing these is encouraged as a cost-containment strategy in the management of healthcare resources. Encouraging the use of generic drugs is widely considered to be the most simple and effective way of reducing medication expenditure.

Perception of generic drugs as fake among Pakistani immigrants

Pakistani immigrants in Norway may confuse generic drugs with counterfeit drugs, according to research carried out by Norwegian researchers [1].

Generic warfarin as safe and effective as brand name

In a literature study by Dr Francesco Dentali and colleagues found that generic warfarin was as safe as brand name warfarin (Coumadin) [1].

Pakistani immigrants may confuse generics with counterfeit drugs

A study by Norwegian researchers showed that generics substitution may lead to lack of compliance in Pakistani immigrants in Norway, due to misconceptions and confusion with counterfeit drugs [1].

Influence these two factors and the use of generics will increase

According to Assistant Professor William Shrank of Harvard Medical School, Boston, USA, we may be able to increase the use of generic alternatives over brand-name medications if we influence the following two factors: communication about generics between patients and their physicians or pharmacists and the patients’ comfort with generic substitution.

Factors that influence generic drug use

Increasing efforts to influence both the prescriber and patient factors involved in determining the type of initial prescription may benefit everyone involved in paying for medications to get the most cost-effective treatment for their condition.

Savings to be made and compliance with generic antidepressants

Vlahiotis A et al. compared discontinuation rates and healthcare utilisation costs among patients using brand-name versus generic antidepressants.

No difference between generic and brand-name antidepressants

Patients who start treatment for depression with generic drugs benefit from significantly lower costs and are just as likely to keep taking their medication as those who start on brand-name medicines new research suggests.

The ‘Wise List’ - a Swedish drug formulary

Research carried out by Lars Gustafsson and et al. [1] into the use and acceptance of a drug formulary used in Stockholm, Sweden, found that adherence to the ‘Wise List’ resulted in substantial cost savings due to increased use of cheaper generic drugs.

Benefits and risks of generic substitution

According to the FDA, each year, Americans save an estimated US$8–10 billion by purchasing generic drugs rather than branded medications. These savings are, of course, the key advantage of generics. However, the very reason for these cost savings—the fact that generic drugs do not have to undergo the large, expensive clinical trials that are required for approval of branded drugs—gives rise to questions about the quality and safety of generics.

Savings due to generic substitution in South Africa

A retrospective analysis of medical claims for antidepressants during 2004–2006 in South Africa calculated potential savings of 9.3% of the actual antidepressant cost over the study period.

Compliance with generic drug use among Pakistani immigrants

Patients using antihypertensives, antidiabetics or cholesterol-lowering drugs were interviewed using a questionnaire in the study which investigated the perceptions of generic substitution among Pakistani immigrants in Oslo, Norway, and how this affected compliance with their long-term drug use and may be affected by confusion of generic drugs with counterfeit drugs [1].

The benefits of generic substitution

Recent research carried out by Drs Lewek and Kardas, showed that generic drugs are equally as safe and effective as their brand-name equivalents. Patient compliance and cost were also found to be better with generics compared to brand-name drugs.

Different routes for generics and brand-name drugs

Comparison of the route to market generics and brand-name drugs was discussed by Dr Lewek and Dr Kardas in their recent research paper on the benefits and risks of generic substitution.

The status of generic substitution in South Africa

In South Africa only around 13% of the population live in what we would call ‘first world’ conditions. More than half the population (around 48 million people) live in developing world conditions according to researchers from the School of Pharmacy at the North-West University, South Africa.

Generic substitution generates savings in South Africa

Savings of 9.3% over the 3-year study period could have been made with generic substitution of antidepressants according to research carried out by the School of Pharmacy at the North-West University, South Africa.

Generic substitution rates in South Africa

Research carried out by the School of Pharmacy at the North-West University, South Africa, has shown that generic substitution rates for antidepressants increased between 2004 and 2006. Meanwhile antidepressant use decreased over the same period while the average cost decreased in 2005, but increased again in 2006.

Bioequivalence of generic cyclosporine

A clinical trial in allogeneic stem cell transplant (ASCT) recipients found that generic and branded cyclosporine could be considered interchangeable.

Value-based pricing – the concept

The concept of value-based pricing (VBP) is outlined. A key purpose of the VBP system is to assess over time whether the drug has achieved its intended goal and justified its cost.

Efficacy and tolerability of generic and branded atorvastatin

In a study carried out in Korean patients the efficacy and tolerability of generic and branded atorvastatin was evaluated and found to be similar in Korean patients at high risk for cardiovascular events.

Generic substitution in Norway

Using a dataset extracted from the Norwegian prescription database containing all prescriptions written in the period January 2004 to June 2007, an analysis was carried out on two brand-name and two generic statin drugs used to treat high cholesterol and showed that prices have a clear impact on generic substitution [1].

Impact of generic substitution in Finland

Mandatory generic substitution was introduced in Finland on 1 April 2003. A recent study compared the impact of generic substitution on both originator and generic pharmaceutical companies in Finland.

Generic substitution causing confusion

How do customers and pharmacists really experience generic substitution? This is the question asked in a recent research article [1].

Generic and branded acetylcysteine bioequivalent

A single-dose study of acetylcysteine 600 mg found that three tablets of 200 mg of the generic formulation given orally were bioequivalent to a single 600 mg tablet of the branded drug.

The clinical equivalence of brand-name beta-blockers and their generic counterparts

The healthcare systems of the world are all under pressure to reduce costs and using generic substitution for the initially prescribed, more expensive equivalents is an obvious area to investigate. However, as a report reiterated in 2010, treatment decisions should not be based on economic grounds alone, for this would not be in the patient's best interest and would therefore be unethical. What is needed is an opinion based on the evidence available regarding therapeutic equivalence [1].

The rise in power of generic drugs

With shrinking pipelines, the impending expiration of many drug patents, and the global economic downturn experienced in the last two years causing prescription payers to face budget cuts, generic drugs are becoming an increasingly large player in the economics of the global pharmaceutical industry.