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2014 ; 4
(1
): 9
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The impact of reference pricing and extension of generic substitution on the
daily cost of antipsychotic medication in Finland
#MMPMID26054399
Koskinen H
; Ahola E
; Saastamoinen LK
; Mikkola H
; Martikainen JE
Health Econ Rev
2014[Dec]; 4
(1
): 9
PMID26054399
show ga
OBJECTIVE: To assess the impact of reference pricing and extension of generic
substitution on the daily cost of antipsychotic drugs in Finland during the first
year after its launch. Furthermore, the additional impact of reference pricing on
prior implemented generic substitution is assessed. METHODS: A retrospective
analysis was performed between 2006 and 2010. A segmented linear regression
analysis of interrupted time series was used to estimate changes in the levels
and trends in the cost of one day of treatment. Of the study drugs, clozapine
belonged to generic substitution already at the start of the study period while
olanzapine and quetiapine were included in generic substitution alongside with
reference pricing in 2009. Risperidone was included in generic substitution in
2008, before reference pricing. RESULTS: A substantial decrease in the daily cost
of all four antipsychotic substances was seen after one year of the
implementation of reference pricing and the extension of generic substitution.
The impact ranged from -29.9% to -66.3%, and it was most substantial on the daily
cost of olanzapine. Also in the daily cost of risperidone a substantial decrease
of -43.3% was observed. However, most of these savings, -32.6%, were generated by
generic substitution which had been adopted prior. CONCLUSIONS: Reference pricing
and the extension of generic substitution produced substantial savings on
antipsychotic medication costs during the first year after its launch, but the
intensity of the impact differed between active substances. Furthermore, our
results suggest that the additional cost savings from reference pricing after
prior implemented generic substitution, are comparatively low.