Essential Medicines and Pharmaceutical Policies, World Health Organization, Geneva, Switzerland.
Value Health. 2012 Jul-Aug;15(5):664-73. doi: 10.1016/j.jval.2012.04.004. Epub 2012 Jul 11.
In low- and middle-income countries, patients and reimbursement agencies that purchase medicines in the private sector pay more for originator brands when generic equivalents exist. We estimated the savings that could be obtained from a hypothetical switch in medicine consumption from originator brands to lowest-priced generic equivalents for a selection of medicines in 17 countries.
In this cost minimization analysis, the prices of originator brands and their lowest-priced generic equivalents were obtained from facility-based surveys conducted by using a standard methodology. Fourteen medicines most commonly included in the surveys, plus three statins, were included in the analysis. For each medicine, the volume of private sector consumption of the originator brand product was obtained from IMS Health, Inc. Volumes were applied to the median unit prices for both originator brands and their lowest-priced generics to estimate cost savings. Prices were adjusted to 2008 by using consumer price index data and were adjusted for purchasing power parity.
For the medicines studied, an average of 9% to 89% could be saved by an individual country from a switch in private sector purchases from originator brands to lowest-priced generics. In public hospitals in China, US $ 370 million could be saved from switching only four medicines, saving an average of 65%. Across individual medicines, average potential savings ranged from 11% for beclometasone inhaler to 73% for ceftriaxone injection.
Substantial savings could be achieved by switching private sector purchases from originator brand medicines to lowest-priced generic equivalents. Strategies to promote generic uptake, such as generic substitution by pharmacists and increasing confidence in generics by professionals and the public, should be included in national medicines policies.
在中低收入国家，当存在仿制药时，患者和购买私人部门药品的报销机构会为原研药支付更高的价格。我们估计，如果在 17 个国家中，将药品的消费从原研药转向价格最低的仿制药，可能会节省多少费用。
在这项成本最小化分析中，原研药及其最低价格仿制药的价格是通过使用标准方法进行的基于医疗机构的调查获得的。该分析包括调查中最常包含的 14 种药品，外加 3 种他汀类药物。对于每种药物，原研药产品在私人部门的消费数量是从 IMS Health, Inc. 获得的。将这些数量应用于原研药及其最低价格仿制药的中位数单位价格，以估计节省的成本。价格根据消费者价格指数数据进行了 2008 年的调整，并根据购买力平价进行了调整。
在所研究的药品中，从私人部门购买原研药转向购买价格最低的仿制药，一个国家平均可以节省 9%至 89%的费用。在中国的公立医院，仅通过转换四种药品，就可以节省 3.7 亿美元，平均节省 65%。在个别药品方面，平均潜在节省幅度从布地奈德吸入器的 11%到头孢曲松注射剂的 73%不等。
通过将私人部门从原研药的购买转向价格最低的仿制药，可以节省大量费用。国家药品政策应包括促进仿制药采用的策略，如药剂师的仿制药替代以及专业人员和公众对仿制药信心的增强。
