Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications
Introduction: The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilisation. However, considerable variation in their use and prices. Objective: Assess the influence of multiple supply and demand-side ini...
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| Format: | Article |
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Frontiers Media S.A.
2014-06-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphar.2014.00106/full |
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| author | Brian eGodman Brian eGodman Brian eGodman Bjorn eWettermark Bjorn eWettermark Bjorn eWettermark Menno eVan Woerkom Jessica eFraeyman Samantha eAlvarez-Madrazo Christian eBerg Iain eBishop Anna eBucsics Stephen eCampbell Alexander E Finlayson Jurij eFurst Kristina eGaruoliene Kristina eGaruoliene Harald eHerholz Marija eKalaba Ott eLaius Jutta ePiessnegger Catherine eSermet Ulrich eSchwabe Vera eV Vlahović-Palčevski Vanda eMarkovic-Pekovic Vanda eMarkovic-Pekovic Luka eVoncina Kamila eMalinowska Kamila eMalinowska Corinne eZara Lars L Gustafsson |
| author_facet | Brian eGodman Brian eGodman Brian eGodman Bjorn eWettermark Bjorn eWettermark Bjorn eWettermark Menno eVan Woerkom Jessica eFraeyman Samantha eAlvarez-Madrazo Christian eBerg Iain eBishop Anna eBucsics Stephen eCampbell Alexander E Finlayson Jurij eFurst Kristina eGaruoliene Kristina eGaruoliene Harald eHerholz Marija eKalaba Ott eLaius Jutta ePiessnegger Catherine eSermet Ulrich eSchwabe Vera eV Vlahović-Palčevski Vanda eMarkovic-Pekovic Vanda eMarkovic-Pekovic Luka eVoncina Kamila eMalinowska Kamila eMalinowska Corinne eZara Lars L Gustafsson |
| author_sort | Brian eGodman |
| collection | DOAJ |
| description | Introduction: The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilisation. However, considerable variation in their use and prices. Objective: Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilise the findings to suggest potential future initiatives that countries could consider. Method: Analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins and renin-angiotensin inhibitor drugs among European countries. Results: Nature and intensity of the various initiatives appreciably influenced prescribing behaviour and expenditure, e.g. multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3 fold increase in utilisation and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilisation. A similarly picture was seen with prescribing restrictions, i.e. (i) more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilisation of patented statins in Austria vs. Norway and lower utilisation of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Conclusions: Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realise appreciable savings. Health authorities cannot rely on a ‘spill over’ effect between classes to affect changes in prescribing |
| first_indexed | 2024-04-12T02:37:10Z |
| format | Article |
| id | doaj.art-723a1d132cd74dffb19afdde8ba3b1c8 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-04-12T02:37:10Z |
| publishDate | 2014-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-723a1d132cd74dffb19afdde8ba3b1c82022-12-22T03:51:29ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122014-06-01510.3389/fphar.2014.0010686536Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implicationsBrian eGodman0Brian eGodman1Brian eGodman2Bjorn eWettermark3Bjorn eWettermark4Bjorn eWettermark5Menno eVan Woerkom6Jessica eFraeyman7Samantha eAlvarez-Madrazo8Christian eBerg9Iain eBishop10Anna eBucsics11Stephen eCampbell12Alexander E Finlayson13Jurij eFurst14Kristina eGaruoliene15Kristina eGaruoliene16Harald eHerholz17Marija eKalaba18Ott eLaius19Jutta ePiessnegger20Catherine eSermet21Ulrich eSchwabe22Vera eV Vlahović-Palčevski23Vanda eMarkovic-Pekovic24Vanda eMarkovic-Pekovic25Luka eVoncina26Kamila eMalinowska27Kamila eMalinowska28Corinne eZara29Lars L Gustafsson30Karolinska InstitutetInstitute of Pharmacy and Biomedical Sciences, University of StrathclydeUniversity of Liverpool Management SchoolKarolinska InstitutetKarolinska InstitutetMedical Knowledge CentreDutch Institute for Rational Use of MedicinesUniversity pf AntwerpInstitute of Pharmacy and Biomedical Sciences, University of StrathclydeNorwegian Institute of Public Health,NHS ScotlandUniversity of ViennaUniversity of ManchesterGreen Templeton College, Oxford UniversityHealth Insurance InstituteUniversity of VilniusHealth Insurance FundKasemarzliche Vereinigung HessenRepublic Institute for Health InsuranceState Agency of MedicinesHauptverband der Österreichischen SozialversicherungsträgerIRDESUniversity of HeidelbergUniversity of RijekaUniversity of Banja LukaMinistry of Health and Social WelfareMinistry of HealthHTA ConsultingThe Medical Centre of Postgraduate EducationCatalan Health ServiceKarolinska InstitutetIntroduction: The appreciable growth in pharmaceutical expenditure has resulted in multiple initiatives across Europe to lower generic prices and enhance their utilisation. However, considerable variation in their use and prices. Objective: Assess the influence of multiple supply and demand-side initiatives across Europe for established medicines to enhance prescribing efficiency before a decision to prescribe a particular medicine. Subsequently utilise the findings to suggest potential future initiatives that countries could consider. Method: Analysis of different methodologies involving cross national and single country retrospective observational studies on reimbursed use and expenditure of PPIs, statins and renin-angiotensin inhibitor drugs among European countries. Results: Nature and intensity of the various initiatives appreciably influenced prescribing behaviour and expenditure, e.g. multiple measures resulted in reimbursed expenditure for PPIs in Scotland in 2010 56% below 2001 levels despite a 3 fold increase in utilisation and in the Netherlands, PPI expenditure fell by 58% in 2010 vs. 2000 despite a 3-fold increase in utilisation. A similarly picture was seen with prescribing restrictions, i.e. (i) more aggressive follow-up of prescribing restrictions for patented statins and ARBs resulted in a greater reduction in the utilisation of patented statins in Austria vs. Norway and lower utilisation of patented ARBs vs. generic ACEIs in Croatia than Austria. However, limited impact of restrictions on esomeprazole in Norway with the first prescription or recommendation in hospital where restrictions do not apply. Similar findings when generic losartan became available in Western Europe. Conclusions: Multiple demand-side measures are needed to influence prescribing patterns. When combined with supply-side measures, activities can realise appreciable savings. Health authorities cannot rely on a ‘spill over’ effect between classes to affect changes in prescribinghttp://journal.frontiersin.org/Journal/10.3389/fphar.2014.00106/fullStatinsgenericsdrug utilisation studiesdemand-side measuresPPIsrenin-angiotensin inhibitor drugs |
| spellingShingle | Brian eGodman Brian eGodman Brian eGodman Bjorn eWettermark Bjorn eWettermark Bjorn eWettermark Menno eVan Woerkom Jessica eFraeyman Samantha eAlvarez-Madrazo Christian eBerg Iain eBishop Anna eBucsics Stephen eCampbell Alexander E Finlayson Jurij eFurst Kristina eGaruoliene Kristina eGaruoliene Harald eHerholz Marija eKalaba Ott eLaius Jutta ePiessnegger Catherine eSermet Ulrich eSchwabe Vera eV Vlahović-Palčevski Vanda eMarkovic-Pekovic Vanda eMarkovic-Pekovic Luka eVoncina Kamila eMalinowska Kamila eMalinowska Corinne eZara Lars L Gustafsson Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications Frontiers in Pharmacology Statins generics drug utilisation studies demand-side measures PPIs renin-angiotensin inhibitor drugs |
| title | Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications |
| title_full | Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications |
| title_fullStr | Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications |
| title_full_unstemmed | Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications |
| title_short | Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications |
| title_sort | multiple policies to enhance prescribing efficiency for established medicines in europe with a particular focus on demand side measures findings and future implications |
| topic | Statins generics drug utilisation studies demand-side measures PPIs renin-angiotensin inhibitor drugs |
| url | http://journal.frontiersin.org/Journal/10.3389/fphar.2014.00106/full |
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