Generic substitution saves nearly €40m in Finland
Generic substitution and associated price reductions have saved €39.8m (£27.8m) in Finland in six months, about 5 per cent of its drugs bill, according to the Social Insurance Foundation of Finland (Kela).
Since 1 April this year, pharmacies have been obliged to supply the cheapest,
or close to the cheapest, generic alternative for a range of branded
products drawn up by the Finnish National Agency for Medicines. The price
is considered to be close to the cheapest if the difference is no more
than €2 for medicines costing less than €40, or no more than €3
above this. Reimbursement to pharmacists and patients is based on the
price of the dispensed product. Patients in Finland pay a fixed fee of
either €5 or €10 per item, plus either 50 per cent, 25 per cent
or none of the additional cost depending on the drug and condition being
treated, up to an annual limit of around €600.
The products have to be pharmacologically and clinically substitutable — containing
the same active substance in the same amount and form — and bioequivalent.
Substitutable products account for 45 per cent of all prescriptions reimbursed
by Kela and 35 per cent of the total costs of reimbursed medicines.
Both prescribers and patients can stipulate that products are not substituted;
patients who do so have to pay the additional cost. In the first six
months of the scheme, substitution was declined by patients for 10.6
per cent of prescriptions. Only 0.4 per cent of prescriptions where substitution
was possible were marked by prescribers to forbid it. Substitutions were
made on 13.7 per cent of all prescriptions, with 72.2 per cent already
being written for the cheapest, or close to cheapest, generic alternative.
Over 500,000 patients received at least one substitution. Kela calculates
that generic substitution and price cuts brought on through competition
have generated €22.2m in savings on drug reimbursement and €17.5m
in savings for purchasing patients, based on March 2003 prices. |
