Titre
Determinants of generic drug substitution in Switzerland.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Decollogny, Anne
Auteure/Auteur
Eggli, Yves
Auteure/Auteur
Halfon, Patricia
Auteure/Auteur
Lufkin Thomas, M.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1472-6963
Statut éditorial
Publié
Date de publication
2011
Volume
11
Première page
art. 17 [12 p.]
Peer-reviewed
Oui
Langue
anglais
Notes
Permalien : http://purl.org/NET/SAPHIR/85478
Résumé
Background: Since generic drugs have the same therapeutic effect as the original formulation but at generally lower costs, their use should be more heavily promoted. However, a considerable number of barriers to their wider use have been observed in many countries. The present study examines the influence of patients, physicians and certain characteristics of the generics' market on generic substitution in Switzerland.Methods: We used reimbursement claims' data submitted to a large health insurer by insured individuals living in one of Switzerland's three linguistic regions during 2003. All dispensed drugs studied here were substitutable. The outcome (use of a generic or not) was modelled by logistic regression, adjusted for patients' characteristics (gender, age, treatment complexity, substitution groups) and with several variables describing reimbursement incentives (deductible, co-payments) and the generics' market (prices, packaging, co-branded original, number of available generics, etc.).Results: The overall generics' substitution rate for 173,212 dispensed prescriptions was 31%, though this varied considerably across cantons. Poor health status (older patients, complex treatments) was associated with lower generic use. Higher rates were associated with higher out-of-pocket costs, greater price differences between the original and the generic, and with the number of generics on the market, while reformulation and repackaging were associated with lower rates. The substitution rate was 13% lower among hospital physicians. The adoption of the prescribing practices of the canton with the highest substitution rate would increase substitution in other cantons to as much as 26%.Conclusions: Patient health status explained a part of the reluctance to substitute an original formulation by a generic. Economic incentives were efficient, but with a moderate global effect. The huge interregional differences indicated that prescribing behaviours and beliefs are probably the main determinant of generic substitution.
PID Serval
serval:BIB_1FF784199105
PMID
Open Access
Oui
Date de création
2011-12-19T10:14:59.774Z
Date de création dans IRIS
2025-05-20T13:57:41Z
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Nom
BIB_1FF784199105.P001.pdf
Version du manuscrit
preprint
Taille
256.93 KB
Format
Adobe PDF
PID Serval
serval:BIB_1FF784199105.P001
URN
urn:nbn:ch:serval-BIB_1FF7841991055
Somme de contrôle
(MD5):2a14e7504ea70adf5931d98384b00699