Generic substitution in Finland: lessons learned during 2003-2008

Abstract

Objectives Obligatory generic substitution (GS) was introduced in Finland in 2003 with the aim of containing medicine costs. In this article The materialized impacts of GS are compared with the impacts that were anticipated before GS was introduced. The implementation of GS in Finland is described from the perspectives of generated savings, patients, physicians and the pharmaceutical distribution chain during the years 2003–2008. Methods The studies in this research project were done between 2003 and 2008. Data were collected by means of questionnaires, interviews and register-based studies. Data from the Social Insurance Institution of Finland regarding GS are also included in this article. Key findings Obligatory GS has been a successful pharmaceutical policy reform in Finland, and it has been quite effectively implemented in practice. GS has generated significant savings in the cost of medicines through substitution and price competition. Finnish patients and physicians have accepted it. GS has also had many anticipated impacts on the parties involved in the pharmaceutical distribution chain. However, some of the anticipated effects, such as medicine availability problems, have not materialized. Conclusions Implementation of pharmaceutical policy reforms should always be evaluated from different perspectives and at the beginning of the reform and several years after it has been introduced.