Blankart, Katharina; Vandoros, Sotiris (2024). Explaining why increases in generic use outpace decreases in brand name medicine use in multisource markets and the role of regulation PLOS ONE, 19(5), e0301716. Public Library of Science 10.1371/journal.pone.0301716
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Background Healthcare systems worldwide face escalating pharmaceutical expenditures despite interventions targeting pricing and generic substitution. Existing studies often overlook unwarranted volume increases in multisource markets due to differential physician perceptions of brand name and generics. Objective This study aims to explain the outpacing of generic medicine use over brand name use in multisource markets and assess the regulatory role, specifically examining the impact of reference pricing on volume and intensity increases. Methods Analyzing German multisource prescription medicine markets from 2011 to 2014, we evaluate regulatory mechanisms and explore whether brand name and generic medicines constitute separate market segments. Using an Oaxaca-Blinder decomposition approach, we divide the differential in brand name versus generic medicine use rates into market structure and unobserved segment effects. Results Generic use rates surpass same-market brand name substitution by 3.87 prescriptions per physician and medicine, on average. Reference pricing mitigated volume increase, treatment intensity and expenditure. Disparities in quantity and expenditure dynamics between brand name and generic segments are partially explained by market structure and segment effects. Conclusion Generic medicine use effectively reduces expenditures but contributes to increased net prescription rates. Reference pricing may control medicine use, but divergent physician perceptions of brand name and generics, revealed by identified segment effects, call for nuanced policy interventions.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
School of Health Professions School of Health Professions > Institute of Health Economics and Health Policy |
Name: |
Blankart, Katharina; Vandoros, Sotiris and Gotham, Dzintars |
Subjects: |
H Social Sciences > H Social Sciences (General) R Medicine > R Medicine (General) |
ISSN: |
1932-6203 |
Publisher: |
Public Library of Science |
Language: |
English |
Submitter: |
Katharina Blankart |
Date Deposited: |
07 May 2024 14:54 |
Last Modified: |
07 May 2024 16:22 |
Publisher DOI: |
10.1371/journal.pone.0301716 |
ARBOR DOI: |
10.24451/arbor.21861 |
URI: |
https://arbor.bfh.ch/id/eprint/21861 |
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