Objectives:
This study aims to conduct a descriptive analysis of the policy
environment surrounding the generic medicines retail market in
Portugal. The policy analysis focuses on supply-side measures
(i.e. market access, pricing, reference-pricing and reimbursement
of generic medicines) and demand-side measures (i.e. incentives
for physicians to prescribe, for pharmacists to dispense and for
patients to use generic medicines).
Methods: The policy analysis was based on an international literature
review. Also, a simulation exercise was carried out to compute
potential savings from substituting generic for originator medicines
in Portugal using IMS Health data.
Results: Portugal has developed a successful generic medicines
market by increasing reimbursement of generic medicines (until
October 2005), by introducing a reference-pricing system, by encouraging
physicians to prescribe by international non-proprietary name
(INN), and by allowing generic substitution by pharmacists. However,
the development of the generic medicines market has been hindered
by the existence of copies, pricing regulation, certain features
of the reference-pricing system, weak incentives for physicians
to prescribe generic medicines and a financial disincentive for
pharmacists to dispense generic medicines. Increased generic substitution
would be expected to reduce public expenditure on originator medicines
by 45%.
Conclusions: The development of the Portuguese generic medicines
market has mainly been fuelled by supply-side measures. To support
the further expansion of the market, policy makers need to strengthen
demand-side measures inciting physicians to prescribe, pharmacists
to dispense and patients to use generic medicines.
