The measures introduced include educating physicians, introduction of prescribing guidance, regional formularies, monitoring of prescribing practices, efficiency and quality targets and financial incentives.

It appears that such measures are having an effect in increasing prescribing of generic PPIs and statins compared to brand-name alternatives.

For example, for omeprazole and simvastatin, generics became available in 2002 and 2003, respectively. This has had a marked effect on the price of these drugs, as can be seen in Figure 1.

Figure 1: Expenditure on generic omeprazole and simvastatin in Scotland, 2005–10 [1]

 
DDD: defined daily dose.

Expenditure/defined daily dose for generic omeprazole in 2010 was 91% below originator prices in 2001. This has resulted in expenditure on omeprazole being 56% lower in 2010 compared to 2001 levels, despite a three-fold increase in omeprazole use. Generic omeprazole makes up 98% of all omeprazole used in Scotland since 2006.

Simvastatin dominates statins use in Scotland, making up around 57% of all statin use. Due to increased use of generic simvastatin, spending on statins in 2010 had increased by only 7% compared to that in 2001, despite a 6.2-fold increase in use of statins. Generic simvastatin now makes up 98% of all simvastatin used in Scotland.

The results of the increasing use of generic drug alternatives for PPI and statin treatments has translated into savings for Scotland’s government estimated at over GBP 159 million for PPIs and GBP 290 million for statins in 2010 alone.

It appears therefore that the measures introduced in Scotland, along with lower generics prices, have certainly had the desired effect in reducing costs. This is in line with results seen in other countries such as Sweden, where similar measures have been introduced.

Related articles

Impact of measures to encourage generics prescribing in Scotland

Prescribing of generic PPIs and statins in Scotland

Reference

1.  Bennie M, Godman B, Bishop I, Campbell S. Multiple initiatives continue to enhance the prescribing efficiency for the proton pump inhibitors and statins in Scotland. Expert Rev Pharmacoecon Outcomes Res. 2012;12(1):125-30. doi:10.1586/erp.11.98