title: [Impact of the expiry of the patent on quality and price of medicines at hospital: Study of five anticancer drugs from 2008 to 2015 at the Assistance publique-Hôpitaux de Paris].
abstract: OBJECTIVE
  Anticancer drugs were in 2005 the first expenditure item of the hospital drugs. Ten years later, it is noted that the placing on the market of generic drugs has led to a strong decrease of their price. To determine whether this decrease comes at the expense of product quality, a price-quality ratio trend study of five anticancer drugs was performed at AP-HP.
  
  
  METHODS
  This work concerns docetaxel, oxaliplatin, gemcitabine, irinotecan and paclitaxel, and focus on the transition period between monopoly conditions and competitive situation (2008 to 2015). The price is set by calculating the cost per milligram of each specialty. Quality is evaluated by the average of quality marks obtained during the analysis of the tenders received in the purchasing procedures on four assessment criteria: ready for use form, stability of the solution after dilution, safety use and labeling.
  
  
  RESULTS
  Between 2008 and 2015, the price per milligram of these anticancer drugs decreases, following the placing on the market of generic drugs. The quality of the tenders is maintained and even improved in many cases. On average, generic rating quality, lower than that of the originators in 2008, are now the highest.
  
  
  CONCLUSIONS
  This study allows an objective basis of the effects of the drop in patent originator medicines. The placing on the market of generic drugs has a double positive result for the buyer: strong price cuts, parallel to the quality improvement, through the example of five anticancer drugs studied.
authors.affiliation: Service évaluations pharmaceutiques et bon usage, AGEPS, AP-HP, 7, rue du Fer-à-Moulin, 75005 Paris, France; UF évaluation et achat des médicaments, agence générale des équipements et des produits de santé (AGEPS), Assistance publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France. Electronic address: virginie.siorat@aphp.fr.
authors.forename: V
authors.initials: V
authors.lastname: Siorat
authors.affiliation: Service évaluations pharmaceutiques et bon usage, AGEPS, AP-HP, 7, rue du Fer-à-Moulin, 75005 Paris, France; UF évaluation et achat des médicaments, agence générale des équipements et des produits de santé (AGEPS), Assistance publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Raybaut
authors.affiliation: Service évaluations pharmaceutiques et bon usage, AGEPS, AP-HP, 7, rue du Fer-à-Moulin, 75005 Paris, France; UF évaluation et achat des médicaments, agence générale des équipements et des produits de santé (AGEPS), Assistance publique-Hôpitaux de Paris (AP-HP), 7, rue du Fer-à-Moulin, 75005 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Poisson
authors.affiliation: Service évaluations pharmaceutiques et bon usage, AGEPS, AP-HP, 7, rue du Fer-à-Moulin, 75005 Paris, France; Faculté de pharmacie de Paris, institut droit et santé, Inserm UMR S 1145, université Paris Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Paubel
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics* / Q000592:standards; D016527:Drug Costs / Q000706:statistics & numerical data*; D016568:Drugs, Generic / Q000191:economics; D005602:France; D006779:Hospitals, Public / Q000191:economics*; D006801:Humans; D010330:Patents as Topic
chemical_list: D000970:Antineoplastic Agents; D016568:Drugs, Generic
keywords: Anticancer drugs; Anticancéreux; Competitive situation; Concurrence; Price; Prix; Quality; Qualité