In the latest years generic medicines allowed to limit the pharmaceutical expenditure, but the appearance of new factors on the market could weaken this role in the future. The report “The Generic medicines role for the healthcare systems sustainability: an European and Italian perspective” published by QuintilesIMS offers causes of reflection and makes proposal on this topic
Healthcare systems sustainability is an issue not limited only to Italy, but it regards also every other countries: surely the European states, but also any others advanced and developing countries in the world. The monitoring and controlling of healthcare expenditure in EU countries have had strong consequences on pharmaceutical expenditure as well: pharmaceutical spending increased slightly or, in some cases, decreased, even though in 2013 it was still about the 20% of total healthcare expenditure.
The increasing importance of the risk factors for the healthcare systems sustainability like:
- Increasing proportion of elderly population with a related larger demand of healthcare services;
- High cost of innovative medicines and high technological medical devices;
- Fewer benefits for healthcare systems because of a constant reduction of number of patent medicines that become off-patent;
impose the adoption of healthcare policies that can guarantee in every country the stabilization of own healthcare system.
In September 2016, IMS Health Study Center of Milan published a short report on this issue entitled The Generic medicines role for the healthcare systems sustainability: an European and Italian perspective. This study analyzes the current role played by generic medicines in cost-containment policy within the European and Italian healthcare frameworks. Furthermore, the report suggests some solutions aimed to guarantee the contribution of this group of medicines again in the future.
Today in Europe the off-patent and generic medicines are used in most treatments, and the choice between the first and the second group is done by a series of factors, included the price. Market share of generic medicines is about 40% of total, even if there’s a strong variability.
In Europe, prescription of generic medicines is surely made easier by price, a key factor that the report specifies to be 61% lower on average than the last one applied when the originator medicine is still under patent. This fact encouraged the access to off-patent medicines and in the same moment the control of pharmaceutical expenditure. During five years from 2010 to 2015, in Italy the average price of medicines under prescription lowered of 15%, despite in the same period one hundred new products was launched on the market.
The main peculiarity of Italian healthcare system is the difference between different regional healthcare system about distribution of generic medicines: the regions of South Italy have a low propensity to distribute this group of medicines. And the lesser penetration of generic drugs in Italian market than other European countries, also caused by the low confidence of Italian people about these medicines, is a factor that increase the out-of-pocket payment by patients.
Generic medicines can help to stabilize European healthcare systems, and this report’s authors highlight some focuses and make some proposals in order to get this goal:
- Cost reduction should not be thought as the main driver in order to act generic medicines policies. Data analysis made in the last years showed that disadvantages are greater than advantages if reduction in the price of medicines is too strong in medium to long term period: for example, generic medicines producer were moving their production away from Europe (mainly toward countries with cheap labour). In some cases, they stopped their production process and closed their plants definitively;
- More competition, a strong demand of medicines, and an more information about the role of generic drug in healthcare system;
- More collaboration between the different healthcare stakeholders: pharmaceutical companies (that produce patent and/or off-patent drugs), distributors, prescribers, pharma retailers, patients;
- Pharmaceutical decision makers should promote best practices and implement actions that allow to evaluate the economic effectiveness of generic medicines. Furthermore, decision makers should promote a better information to stakeholders about this groups of medicines, safeguarding the citizens’ freedom of choice but rewarding the generic drug option. In the end, decision makers should monitor the whole pharmaceutical production chain in order to allow the access to medicines.