The impact of pharmaceutical pricing and reimbursement policies on generics uptake: implementation of policy options on generics in 29 European countries─an overview

Abstract

Introduction: To describe pharmaceutical pricing and reimbursement systems in 29 European countries with regard to medicines, particularly generics, and their possible impact on generics uptake. Method: Data collection on pharmaceutical pricing and reimbursement policies with the staff of competent authorities. Results: In most European countries the prices of medicines are controlled at the stage of manufacture (ex-factory price) or wholesale. Usually, price control systems target reimbursable medicines, and the prices of reimbursable generics are regulated. Sixteen of the 29 countries surveyed in this study apply a policy of generic price linkage, i.e. setting the price of the generic medicines at a specific percentage lower than that of the originator. Twenty-two of the surveyed countries run a reference price system, i.e. a reimbursement policy based on clusters of identical or similar medicines for which a fixed amount of reimbursement is granted. Most countries cluster medicines with the same active ingredient, and only a few countries have opted for broader reference groups, thus allowing more interchangeability between choice of medicines and higher savings on costs. Demand-side measures such as generics substitution and/or prescribing by the international non-proprietary name are in place in nearly all the countries surveyed. These are usually not mandatory for the stakeholders concerned. Conclusion: As many pharmaceutical policies tend to address reimbursable medicines, generics fall under the scope of these measures. European countries apply a mix of specific measures to promote generics uptake. There appears to be room for improvement regarding the enforcement of some policies.