Sustaining Generic Medicines Markets in Europe

Sustaining generic medicines markets 284.2.5 Incentives for patientsIn the Netherlands, patients don’t have a financial incentive to buy generic medicines becausethere are no patient co-payments, except for the difference between the price of the medicine andthe RP if the patient buys a medicine priced above the level of the RP. A specific policy measuretargets three active substances (omeprazole, pravastatin and simvastatin). For these activesubstances, reimbursement is granted on the basis of the medicine with the lowest pharmacyacquisition cost plus a pharmacist margin. No campaigns to raise patient awareness of genericmedicines have been run.4.3 Policy analysisThe main driver of generic medicines use in the Netherlands is the financial attractiveness ofgeneric substitution to pharmacists. A financial incentive and discounts awarded bypharmaceutical companies has encouraged pharmacists to dispense generic medicines.However, competition in the form of discounts to pharmacists rather than by price implies thathealth insurance funds do not fully benefit from the cost-saving potential of generic medicines. Inresponse to this, a claw-back mechanism was introduced. This type of government intervention isunlikely to be as efficient as a market mechanism where pharmaceutical companies compete onthe basis of prices rather than discounts to pharmacists.Additionally, the Dutch generic medicines market is supported by the lower prices of genericmedicines. The Government has provided a range of financial and non-financial incentives forphysicians to prescribe generic medicines, but adherence to these incentives is voluntary. Healthinsurance funds have set generic substitution target rates in consultation with pharmacists.Key factors aiding the development of the generic medicines market:• The financial attractiveness of generic substitution by pharmacists sustains genericmedicines use• The generic medicines market is driven by the lower prices of generic medicines• A range of financial and non-financial incentives for physicians support generic prescribing• Health insurance funds have agreed generic substitution target rates in consultation withpharmacistsKey factors hindering the development of the generic medicines market:• Patients have few incentives to buy generic medicines