Payers endorse generics to enhance prescribing efficiency: impact and future implications, a case history approach

Brian Godman, Mohammed Abuelkhair, Agnes Vitry, Shajahan Abdu, Marion Bennie, Iain Bishop, Harald Herholz, Andrew Martin, Catherine Sermet

Research output: Contribution to journalArticlepeer-review


Pharmaceutical expenditure continues to rise driven by a number of factors including ageing populations and the continued launch of new premium-priced drugs. Increasing use of generics versus originators and patent-protected products of the same or related classes can help conserve valuable resources. However, concerns with their effectiveness and safety compared to originators as well as only limited introduction of measures to promote their demand in some countries have led to variable use among countries. Countries need to learn from each other to further enhance their prescribing efficiency. Firstly to review successful case histories from different countries, and secondly, raise awareness about potential pitfalls that could undermine the success of future measures in order to provide future guidance on conserving resources in relation to generics. A narrative review of case histories selected by co-authors using a range of different approaches. Systematic reviews are published elsewhere. Twelve case histories were selected depicting both supply- and demand-side measures. These include Croatia where the introduction of additional measures helped reduce drug expenditure as well as debt whilst improving access to new medicines, Lithuania where recent reforms decreased pharmaceutical expenditure in 2010 whilst the number of prescriptions increased by 9% versus 2009; Scotland where despite a 6.2 fold increase in statin utilisation, multiple measures limited the increase in reimbursed expenditure to just 7% in 2010 vs 2001; Sweden where the introduction of monthly auctions for generics has helped lower prices; and the US where managed care organisations actively encourage cross therapeutic opportunities for generics substitution where the safety and efficacy of a generic drug is similar to a patent-protected product in the class or related class to conserve resources. Payers across Australia, Europe, Middle East (United Arab Emirates), and US have introduced multiple measures to both enhance the prescribing of generics and obtain lower prices, with the result that they are increasingly able to take advantage of the availability of generics. However, due to growing pressures on healthcare resources, it is important that countries accelerate the sharing of lessons learned about which policies and new measures are most effective in controlling costs.
Original languageEnglish
Pages (from-to)69-83
Number of pages15
JournalGenerics and Biosimilars Initiative journal
Issue number2
Early online date6 May 2012
Publication statusPublished - 2012


  • generics
  • demand-side measures
  • pharmaceuticals
  • pharmaceutical pricing


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