Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, Groningen University for Drug Exploration (GUIDE), Groningen, The Netherlands.
Appl Health Econ Health Policy. 2005;4(3):191-6. doi: 10.2165/00148365-200504030-00008.
In order to increase price competition, government regulations focus on controlling drug costs. Drug costs after patent expiry are an area of particular interest because the substitution of branded medication with generics represents an opportunity for lowering drug costs. However, drug costs may not decrease after patent expiry, because of a lack of price competition and different national pricing systems.
The aim of this study was to investigate the trends in the use of generics after patent expiry for enalapril, fluoxetine and ranitidine and the subsequent changes, if any, in the costs of these medications.
A drug-utilisation study was performed using data from a large sample of Dutch pharmacies. Both volumes (measured as defined daily doses [DDD] per 1000 population) as well as drug costs (calculated per DDD) prior to and after patent expiry were calculated. Costs per DDD were compared using trend-line analysis. In addition, the relative market shares of the different trade channels (branded, parallel imported and generic) were compared before and after patent expiry.
The costs per DDD decreased for all three drugs and, as expected, these costs decrease more rapidly after patent expiry. Significant differences in the trend lines were found for enalapril and fluoxetine.
Despite relatively high reimbursement prices for generics in the Netherlands, this example from the Dutch pharmaceutical market demonstrates the benefit of generic substitution for containing pharmaceutical costs, which contrasts with concerns raised by the Dutch government.
为了增加价格竞争，政府法规侧重于控制药品成本。专利到期后的药品成本是一个特别关注的领域，因为用仿制药替代品牌药物为降低药品成本提供了机会。然而，由于缺乏价格竞争和不同的国家定价系统，专利到期后药品成本可能不会降低。
本研究旨在调查依那普利、氟西汀和雷尼替丁专利到期后仿制药使用趋势，并研究这些药物的成本是否发生任何变化。
采用荷兰大型药店的大量数据进行药物利用研究。在专利到期前后，计算了每个药物的剂量（以每 1000 人口的日剂量 [DDD] 衡量）和药物成本（以每个 DDD 计算）。使用趋势线分析比较每个 DDD 的成本。此外，在专利到期前后比较了不同贸易渠道（品牌、平行进口和通用）的相对市场份额。
所有三种药物的每个 DDD 成本都降低了，并且正如预期的那样，专利到期后这些成本下降得更快。依那普利和氟西汀的趋势线存在显著差异。
尽管荷兰对仿制药的报销价格相对较高，但荷兰药品市场的这个例子证明了用仿制药替代控制药品成本的好处，这与荷兰政府提出的担忧形成了对比。
