SynthesisApplied health economics and health policy2015
The Impact of Generic Substitution on Health and Economic Outcomes: A Systematic Review.
Synthesis in Applied health economics and health policy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is There Any Research Evidence Beyond Surveys and Opinion Polls on Automatic Substitution of Biological Medicines? A Systematic Review.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2021Pooled it
- Utilisation of antibiotics in a community pharmacy: A case from north-west, South Africa.African journal of primary health care & family medicine · 2025Article
- Testing the unintended cost effects of health policies for generic substitutions: the case of China's National Volume-Based Procurement (NVBP) policy.Health policy and planning · 2025Article
- Explaining why increases in generic use outpace decreases in brand name medicine use in multisource markets and the role of regulation.PloS one · 2024Article
- A nationwide survey exploring physicians' and pharmacists' knowledge, awareness and perceptions regarding generic medicines in China.BMC health services research · 2022Article
- Generic Drug Usage in Dentistry across Japan: Analysis Using a Japanese National Database.International journal of environmental research and public health · 2021Article
- Stakeholder driven development of a multi-criteria decision analysis tool for purchasing off-patent pharmaceuticals in Kuwait.Journal of pharmaceutical policy and practice · 2019Article
- "No generics, Doctor!" The perspective of general practitioners in two French regions.BMC health services research · 2017Observational
- Generic formulations of psychotropic medications and treatment response.Journal of psychiatry & neuroscience : JPN · 2017Article
- Evaluation of the effects of a generic substitution policy implemented in Chile.BMJ global health · 2017Article
- Physicians' Trust in the FDA's Use of Product-Specific Pathways for Generic Drug Approval.PloS one · 2016Article
- Clinical implications for substandard, nonproprietary medicines in multiple sclerosis: focus on fingolimod.Drug design, development and therapy · 2016Review
- Safety and Quality of Generic Drugs: A Never Ending Debate Fostered by Economic Interests?Applied health economics and health policy · 2015Article
- Utilization of free medication samples in the United States in a nationally representative sample: 2009-2013.Research in social & administrative pharmacy : RSAPArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGeneric drugs are considered therapeutically equivalent to their original counterparts and lower in acquisition costs. However, the overall impact of generic substitution (GS) on global clinical and economic outcomes has not been conclusively evaluated.
objectiveTo test whether (1) generics and original products yield the same health outcomes, and (2) generic therapies save economic resources versus original therapies.
methodsWe performed a systematic literature review in Medline, Embase, and the Cochrane Database of Systematic Reviews to identify original studies that examine clinical or economic outcomes of GS. After standardized data extraction, reported outcomes were categorized as supporting or rejecting the hypotheses. Each reported outcome was assessed and accounted for supporting and opposing GS. One publication could provide multiple outcome comparisons.
resultsWe included 40 studies across ten therapeutic areas. Fourteen studies examined patients on de novo therapy; 24 studies investigated maintenance drug therapy, and two studies considered both settings. Overall, 119 outcome comparisons were examined. Of 97 clinical outcome comparisons, 67% reported no significant difference between generic drugs and their off-patent counterparts. Of 22 economic comparisons, 64% suggested that GS increased costs. Consequently, hypothesis (1) was supported but hypothesis (2) was not. We found no major differences among studies that investigated clinical outcomes with de novo or maintenance therapy.
conclusionThe review suggests that clinical effects are similar after GS. However, economic savings are not guaranteed. More systematic research comparing clinical and economic outcomes with or without GS is needed to inform policy on the use of generic substitution.
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