Abstract
ABSTRACTOBJECTIVETo evaluate trends in the use of generic and non-generic medicines to treat hypertension and diabetes under the Farmácia Popular Program (FP) and its impact on generic medicines sales volume and market share in the Brazilian pharmaceutical market.METHODSThis longitudinal, retrospective study used interrupted time series design to analyze changes in monthly sales volume and proportion of medicines sales (market share) for oral antidiabetic and antihypertensive medicines for generic versus non-generic products. Analyses were conducted in a combined dataset that aggregate monthly sales volumes from the Farmácia Popular program and from the QuintilesIMS™ (IQVIA) national market sales data from January 2007 to December 2012. The Farmácia Popular program phases analyzed included: a) 2009 reductions in medicines reference prices (AFP-II) and b) 2011 implementation of free medicines program for hypertension and diabetes, the Saúde não tem preço (SNTP – Health has no price).RESULTSPatterns of use for FP-covered antidiabetic and antihypertensive medicines were similar to their use in the market in general. After one year of the decreases in government subsidies in April 2010, market share of antidiabetic and antihypertensive medicines experienced relative declines of -54.5% and -59.9%, respectively. However, when FP-covered medicines were made free to patients, overall market volume for antidiabetic and antihypertensive generics increased dramatically, with 242.6% and 277.0% relative increases by February 2012, as well as non-generics with relative increase of 209.7% and 279% for antidiabetic and antihypertensive medicines, respectively.CONCLUSIONSMinistry of Health policies on the amount of patient cost sharing and on the choice of medicines on coverage lists have substantial impacts on overall generic sales volume in retail pharmacies.
Highlights
Access to medicines is one of the key elements in ensuring the right to health
This study focuses on three phases of the Farmácia Popular Program (FP)
During the entire study period, FP accounted for a substantial share of the overall Brazilian market for oral antidiabetic and antihypertensive medicines (Table 1, a and b)
Summary
Access to medicines is one of the key elements in ensuring the right to health. its high burden in health systems budgets, especially in low and middle-income countries, represents a challenge to be overcome[1]. One of the strategies meant to reduce the cost of medicines is the use of generics. Generics are defined as “(...) a pharmaceutical product, usually intended to be interchangeable with an innovator product (...)”a.The World Health Organization (WHO) recommends facilitating early market entry of generics and allowing substitution by dispensers to reduce medicine budgets and improve access to medicines[2]. Brazil is a country that recognizes the right to health, including access to medicines as a right of its citizens[3]. In 1998, the Brazilian National Medicines Policy promoted the use of generics by several strategies[4]. The use of generics has been growing and a recent national household survey demonstrated that about half of the interviewees (45.5%) used at least one generic medicine in treating chronic diseases or a recent acute illness[6]
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