Policy objective of generic medicines from the investment perspective: The case of clopidogrel.
The objective of generic drug policies in most countries is defined from a disinvestment perspective: reduction in expenditures without compromising health outcomes. However, in countries with restricted access of patients to original patented drugs, the objective of generic drug policies can also be defined from an investment perspective: health gain by improved patient access without need for additional health budget. This study examines the investment aspect of generic medicines by analyzing clopidogrel utilization in European countries between 2004 and 2014 using multilevel panel data models. We find that clopidogrel consumption was strongly affected by affordability constraints before the generic entry around 2009, but this effect decayed by 2014. After controlling for other variables, utilization had a substantially larger trend increase in lower-income European countries than in the higher-income ones. Generic entry increased clopidogrel consumption only in lower- and average-income countries but not in the highest-income ones. An earlier generic entry was associated with a larger effect. The case of clopidogrel indicates that the entrance of generics may increase patient access to effective medicines, most notably in lower-income countries, thereby reducing inequalities between European patients. Policymakers should also consider this investment aspect of generic medicines when designing pharmaceutical policies.
Department of Economics, Eötvös Loránd University (ELTE), H-1117 Budapest, Pázmány Péter sétány 1/A, Hungary. Electronic address: peter.elek@tatk.elte.hu.
Péter
P
Elek
Department of Health Policy and Health Economics, Eötvös Loránd University (ELTE), H-1117 Budapest, Pázmány Péter sétány 1/A, Hungary. Electronic address: harsanyia@caesar.elte.hu.
András
A
Harsányi
Department of Health Policy and Health Economics, Eötvös Loránd University (ELTE), H-1117 Budapest, Pázmány Péter sétány 1/A, Hungary; Syreon Research Institute, H-1142 Budapest, Mexikói út 65A, Hungary. Electronic address: tamas.zelei@tatk.elte.hu.
Tamás
T
Zelei
Syreon Research Institute, H-1142 Budapest, Mexikói út 65A, Hungary. Electronic address: kata.csetneki@syreon.eu.
Kata
K
Csetneki
Department of Health Policy and Health Economics, Eötvös Loránd University (ELTE), H-1117 Budapest, Pázmány Péter sétány 1/A, Hungary; Syreon Research Institute, H-1142 Budapest, Mexikói út 65A, Hungary. Electronic address: kalo@tatk.elte.hu.
Zoltán
Z
Kaló
D000077144:Clopidogrel; D003906:Developing Countries / Q000706:statistics & numerical data; D016527:Drug Costs / Q000331:legislation & jurisprudence; D016568:Drugs, Generic / Q000191:economics*; D005060:Europe; D006291:Health Policy; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000191:economics*; D012959:Socioeconomic Factors; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000191:economics
D016568:Drugs, Generic; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine
Clopidogrel; Generic drugs; Multilevel analysis; Patient access; Pharmaceutical policy