Faculty of Health Sciences, Institute for Health Insurance, University of Pécs, Vörösmarty U. 3, 7621, Pécs, Hungary.
National Laboratory for Human Reproduction, Ifjúság Útja 20, Pécs, 7624, Hungary.
BMC Health Serv Res. 2023 May 6;23(1):447. doi: 10.1186/s12913-023-09431-6.
Generic competition is a vital health policy tool used in regulating the pharmaceutical market. Drug group HMG-CoA reductase (3-hydroxy-3-methyl-glutaryl-coenzyme-A reductase) inhibitors, widely known as "statins," was the first drug group in Hungary in which generic prescriptions became mandatory. Our aim is to analyze the changes in the retail and wholesale margins through the generic competition regarding "statins".
Data was derived from the nationwide pharmaceutical database of the Hungarian National Health Insurance Fund Administration, the only health care financing agency in Hungary. We observed the turnover data regarding the HMG-CoA-reductase inhibitor "statins" from 2010 through 2019. As the drugs under review have a fixed price point in Hungary, we effectively calculated the margins.
In 2010, the consumer expenditure of statins was 30.7 billion HUF ($148 million), which decreased by 59%, to 12.5 billion HUF ($42.9 million) in 2019. In 2010, the annual health insurance reimbursement of statins was 23.7 billion HUF ($114 million), which underwent a 63% decrease to 8.6 billion HUF ($29.7 million) in 2019. In 2010, the DOT turnover was 287 million days, and it increased to above 346 million days for 2019, which reflects a 20% increase over the past nine years. The monthly retail margins decreased from 334 million HUF ($1.6 million), (January, 2010) to 176 million HUF ($0.61 million), (December, 2019). The monthly wholesale margins decreased from 96.3 million HUF ($0.46 million), (January, 2010) to 41.4 million HUF ($0.14 million), (December, 2019). The most significant downturn in margins was due to the introduction of the first two blind bids. The combined DOT turnover in reference to the examined 43 products consistently increased.
The decline in retail and wholesale margin and in health insurance expenditures was largely due to a reduction in the consumer price of generic medicines. DOT turnover of statins also increased significantly.
仿制药竞争是一种用于规范药品市场的重要卫生政策工具。HMG-CoA 还原酶（3-羟基-3-甲基戊二酰辅酶 A 还原酶）抑制剂类药物（俗称“他汀类药物”）是匈牙利第一个强制使用仿制药的药物类别。我们的目的是分析通过仿制药竞争，他汀类药物的零售和批发利润率的变化。
数据来源于匈牙利国家健康保险基金管理局（匈牙利唯一的医疗保健融资机构）的全国药品数据库。我们观察了 2010 年至 2019 年 HMG-CoA 还原酶抑制剂“他汀类药物”的营业额数据。由于审查中的药物在匈牙利有固定的价格点，因此我们可以有效地计算利润率。
2010 年，他汀类药物的消费者支出为 307 亿匈牙利福林（合 1.48 亿美元），到 2019 年下降了 59%，至 125 亿匈牙利福林（合 4290 万美元）。2010 年，他汀类药物的年健康保险报销额为 237 亿匈牙利福林（合 1.14 亿美元），2019 年下降了 63%，至 86 亿匈牙利福林（合 2.97 亿美元）。2010 年，药品销售点（DOT）营业额为 2.87 亿天，到 2019 年增加到 3.46 亿天以上，这反映了过去九年增长了 20%。每月的零售利润率从 3.34 亿匈牙利福林（合 160 万美元）（2010 年 1 月）下降到 1.76 亿匈牙利福林（合 61 万美元）（2019 年 12 月）。每月的批发利润率从 9630 万匈牙利福林（合 46 万美元）（2010 年 1 月）下降到 4140 万匈牙利福林（合 140 万美元）（2019 年 12 月）。利润率的最大降幅是由于前两次盲标投标的引入。参考审查的 43 种产品的 DOT 营业额总和显著增加。
零售和批发利润率以及健康保险支出的下降主要是由于仿制药消费者价格的降低。他汀类药物的 DOT 营业额也显著增加。
