ArticlePLoS medicine2013
Patented drug extension strategies on healthcare spending: a cost-evaluation analysis.
Article in PLoS medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
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- Trends in the utilization of medicines sold in the private sector post- registration in South Africa and the implications for similar countries.BMC public health · 2023Article
- Effects of Volume-Price Contracts on Pharmaceutical Prices: A Retrospective Comparative Study of Public Hospitals in Hubei of China.Frontiers in pharmacology · 2021Article
- Utilisation Trend of Long-Acting Insulin Analogues including Biosimilars across Europe: Findings and Implications.BioMed research international · 2021Article
- Cost-effectiveness of HLA-DQB1/HLA-B pharmacogenetic-guided treatment and blood monitoring in US patients taking clozapine.The pharmacogenomics journal · 2019Article
- Branded prescription drug spending: a framework to evaluate policy options.Journal of pharmaceutical policy and practice · 2017Article
- Snapshot of the prescribing practice for the clopidogrel and esomeprazole coprescription and cost evaluation of the application guidelines.Pharmacology research & perspectives · 2016Article
- Strategies that delay or prevent the timely availability of affordable generic drugs in the United States.Blood · 2016Article
- Trans-Pacific Partnership Provisions in Intellectual Property, Transparency, and Investment Chapters Threaten Access to Medicines in the US and Elsewhere.PLoS medicine · 2016Article
- Drug Pricing Evolution in Hepatitis C.PloS one · 2016Article
- Designing economic evaluations to facilitate optimal decisions: the need to avoid bias.ClinicoEconomics and outcomes research : CEOR · 2016Article
- Recent trends in specialty pharma business model.Journal of food and drug analysis · 2015Review
- Health Care Utilization and Treatment Persistence Associated with Oral Paliperidone and Lurasidone in Schizophrenia Treatment.Journal of managed care & specialty pharmacy · 2015Article
- Rising health care costs and life-cycle management in the pharmaceutical market.PLoS medicine · 2013Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDrug manufacturers have developed "evergreening" strategies to compete with generic medication after patent termination. These include marketing of slightly modified follow-on drugs. We aimed to estimate the financial impact of these drugs on overall healthcare costs and also to examine the impact of listing these drugs in hospital restrictive drug formularies (RDFs) on the healthcare system as a whole ("spillover effect"). METHODS AND
findingsWe used hospital and community pharmacy invoice office data in the Swiss canton of Geneva to calculate utilisation of eight follow-on drugs in defined daily doses between 2000 and 2008. "Extra costs" were calculated for three different scenarios assuming replacement with the corresponding generic equivalent for prescriptions of (1) all brand (i.e., initially patented) drugs, (2) all follow-on drugs, or (3) brand and follow-on drugs. To examine the financial spillover effect we calculated a monthly follow-on drug market share in defined daily doses for medications prescribed by hospital physicians but dispensed in community pharmacies, in comparison to drugs prescribed by non-hospital physicians in the community. Estimated "extra costs" over the study period were €15.9 (95% CI 15.5; 16.2) million for scenario 1, €14.4 (95% CI 14.1; 14.7) million for scenario 2, and €30.3 (95% CI 29.8; 30.8) million for scenario 3. The impact of strictly switching all patients using proton-pump inhibitors to esomeprazole at admission resulted in a spillover "extra cost" of €330,300 (95% CI 276,100; 383,800), whereas strictly switching to generic cetirizine resulted in savings of €7,700 (95% CI 4,100; 11,100). Overall we estimated that the RDF resulted in "extra costs" of €503,600 (95% CI 444,500; 563,100).
conclusionsEvergreening strategies have been successful in maintaining market share in Geneva, offsetting competition by generics and cost containment policies. Hospitals may be contributing to increased overall healthcare costs by listing follow-on drugs in their RDF. Therefore, healthcare providers and policy makers should be aware of the impact of evergreening strategies.
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