Impact of antiretroviral generics on the Italian National Health Service

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Impact of antiretroviral generics on the Italian National Health Service

Generics/Research | Posted 09/10/2015 0 Post your comment

The cost of antiretroviral therapies (ART) for the treatment of human immunodeficiency virus (HIV), which is now considered a chronic disease [1], represents an increasing burden for healthcare services worldwide. In particular, the availability on the market of new antiretroviral drugs, often more effective and more expensive than those available, lead to the need to identify cost containing strategies to ensure the economic sustainability of the healthcare service and to provide effective treatments to patients. Over the next few years, several patents for antiretroviral drugs will expire, giving the possibility for generics to enter the market. The availability of new generics on the market, may lead to a lowering of ART costs, and therefore to the affordability to provide the aforementioned new and innovative drugs.

A recent study [2] assessed the impact on the budget of the Italian National Health Service of antiretroviral generics and of new ART entering the market between 2015 and 2019. In order to inquire if the savings due to the use of generics could balance the increased cost of the new antiretroviral treatments, the budget impact of these two categories of treatments was investigated both separately and cumulatively.

The potential impact of generics and new antiretroviral drugs was estimated developing a budget impact model based on the rate of consumption of ART observed in the Lombardy Region of Italy and on clinical experts’ opinion, using undiscounted prices referred to 2015 level.

The consumption of generics increased each semester, starting from 12,846 patients receiving at least one generic drug in 2015 to 50,866 in 2019.

The impact of generics would lead to savings of Euros 4.9 million in 2015, Euros 18.6 million in 2016, Euros 22.8 million in 2017, Euros 76.5 million in 2018 and Euros 187.4 million in 2019. The cumulative use of generics and new drugs would lead to annual savings of Euros 4.6 million (-0.6% compared to the do nothing scenario) in 2015; Euros 16.9 million (-2.1%) in 2016; Euros 19.4 million (-2.4%) in 2017; Euros 51.1 million (-6.1%) in 2017 and Euros 110.3 million (-12.8%) in 2019.

Among the possible strategies to manage HIV-positive patients in a sustainable way, the increase of the use of generics is likely to be one of the most practicable.

The study showed how the use of antiretroviral generics may lead to savings for the Italian National Health Service and compensate for any expenditure increase due to the use of new, originator drugs available on the market.

The main limitation of the study is the fact that it considered the sole cost of ART, not evaluating their impact on other medical costs (outpatient activities, hospitalization, use of other drugs) and their effectiveness, which was considered to be equal to that of brand-name drugs.

Conflict of interest
The authors of the research paper [2] declared that there were no conflicts of interest.

Abstracted by Umberto Restelli,PhD,Centre for Research on Organisation, Innovation and Leadership in Healthcare (CROILS), Italy.

Editor’s comment
Readers interested to learn more about cost-savings to be made with generics in Europe are invited to visit www.gabi-journal.net to view the following manuscript published in GaBI Journal:

A review of generic medicine pricing in Europe

Readers interested in contributing a research or perspective paper to GaBI Journal – an independent, peer reviewed academic journal – please send us your submission here.

Italian austerity measures include generic price cuts

References
1. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet.2013;382(9903):1525-33.
2. Restelli U, Scolari F, Bonfanti P, Croce D, Rizzardini G. New highly active antiretroviral drugs and generic drugs for the treatment of HIV infection: a budget impact analysis on the Italian National Health Service (Lombardy Region, Northern Italy). BMC Infect Dis. 2015;15(1):323.

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