Puig-Junoy Jaume
Centro de Investigación en Economía y Salud, Departamento de Economía y Empresa, Universitat Pompeu Fabra, Barcelona, España.
Gac Sanit. 2010 May-Jun;24(3):193-9. doi: 10.1016/j.gaceta.2009.12.003. Epub 2010 Mar 1.
To describe alternative policies aimed at encouraging price competition in generic drug markets in countries with strict price regulation, and to present some case studies drawn from the European experience.
Systematic literature review of articles and technical reports published after 1999.
The shortcomings in consumer price competition observed in some European generic markets, including Spain, may be reduced through three types of public reimbursement or financing reforms: policies aimed at improving the design of current maximum reimbursement level policies; policies aimed at monitoring competitive prices in order to reimburse real acquisition cost to pharmacies; and, more radical and market-oriented policies such as competitive tendering of public drug purchases. The experience of recent reforms adopted in Germany, Belgium, Holland, Norway, and Sweden offers a useful guide for highly price-regulated European countries, such as Spain, currently characterized by limited consumer price competition and the high discounts offered to pharmacy purchases.
Direct price regulation and/or the generic reference pricing systems used to reduce generic drug prices in many European countries can be successfully reformed by adopting measures more closely aimed at encouraging consumer price competition in generic drug markets.
描述旨在鼓励在价格监管严格的国家的仿制药市场进行价格竞争的替代政策,并介绍一些源自欧洲经验的案例研究。
对1999年后发表的文章和技术报告进行系统的文献综述。
在包括西班牙在内的一些欧洲仿制药市场中观察到的消费者价格竞争方面的不足,可以通过三种类型的公共报销或融资改革来减少:旨在改进当前最高报销水平政策设计的政策;旨在监测竞争价格以便向药店报销实际采购成本的政策;以及更激进的、以市场为导向的政策,如公共药品采购的竞争性招标。德国、比利时、荷兰、挪威和瑞典最近进行的改革经验,为西班牙等目前消费者价格竞争有限且药店采购折扣高的价格监管严格的欧洲国家提供了有益的指导。
通过采取更直接旨在鼓励仿制药市场消费者价格竞争的措施,可以成功改革许多欧洲国家用于降低仿制药价格的直接价格监管和/或仿制药参考定价系统。