Competition in the off-patent medicine market in Spain: The national reference pricing system versus the regional system of tendering for outpatient prescription medicines in Andalusia |
| |
| Affiliation: | 1. Villa 7, Compound 26, 2c street, Al Safa 2, DUBAI/ EAU, Spain;2. Rosario Pino 8, 2-C, Madrid, 28020, Spain;3. Andalusian School of Public Health, Instituto de Investigación Biosanitaria (ibs. Granada), Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;1. Karl Polanyi Institute of Political Economy, Concordia University, Montreal, Canada;2. School of Public Policy and Administration, Carleton University (RH-5224), 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada;1. Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan;2. Department of Gerontological Home Care and Long-Term Care Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Japan;3. Cancer Institute Hospital of Japanese Foundation for Cancer Research, Japan;1. Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, USA;2. Policy Research Group, University of Cambridge, UK;3. Faculty of Economics and Business, University of Groningen, the Netherlands;4. Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Croatia;5. Faculty of Arts, Masaryk University, Czech Republic;6. Predictive Psychometrics Laboratory, University of Lincoln, UK;7. Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, USA;8. Department of Social Psychology and Methodology Department, Psychology Faculty, Universidad Autónoma de Madrid, Spain;1. Medical University of Vienna, Center for Public Health, Vienna, Austria;2. University of Vienna, Department for Applied Psychology: Work, Education and Economy, Vienna, Austria |
| |
| Abstract: | Spain has a reference price system (RPS) for off-patent medicines since 1997. In addition, from 2012, Andalusia is running a series of tenders for procuring off-patent medicines dispensed by community pharmacies, for those medicines included in the system of homogenous clusters within the national reference price system. Such tenders offer additional savings to the regional payer – in the form of rebates (“economic improvements”) from companies winning the tender. This paper estimates that the regional savings were between €43 M to €54 M over the period of study (April – September 2015). The paper also estimates that Spain could have made between 14 and 17 times higher savings than the national reference pricing system savings, had the Andalusian-type tender been implemented at national level over the same period of study. Based on our analysis, we have four remarks. First, the national RPS in Spain is not generating enough price competition for off-patent products dispensed in primary care pharmacies. Second, tenders can be a useful way to generate competition and financial savings in the off-patent market. Third, tenders can lead to discounts offered by medicine providers being redistributed from pharmacies to payers. And fourth, before implementing a national tender in Spain, several key issues need to be addressed to ensure it provides the right incentives both in the short and long run. |
| |
| Keywords: | Off-patent medicine market Tendering Reference pricing system Tenders Competition Generics Homogeneous clusters of medicines Regulatory efficiency Price regulation Reimbursement policies INN prescribing |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
