Measures to encourage the use of generics were introduced in the Republic of Srpska under the auspices of the 4Es – education, engineering, economics and enforcement. The measures include encouraging International Nonproprietary Name (INN) prescribing, ensuring that pharmacists offer patients the cheapest product once generics are available, financial incentives to encourage rational prescribing and patient co-payments.

A reference price system for generics was also introduced in the Republic of Srpska in May 2008. This means that patients are only reimbursed for the cost of the lowest priced drug, with any additional costs being covered by the patient.

A study of proton pump inhibitors (PPIs), statins and renin-angiotensin inhibitor drugs showed that there was decreasing expenditure/defined daily dose (DDD) in each of these three drug classes of up to 82% between 2004 and 2010. In addition, reimbursed expenditure/DDD for omeprazole, simvastatin and enalapril, as well as fixed-dose combination angiotensin converting enzyme inhibitors, were similar in the Republic of Srpska to a number of European countries and regions with varying population sizes.

The results show that a country with a small population can introduce a range of supply- and demand-side measures to enhance prescribing efficiency in classes where the products are similar in all or nearly all patients. The results have therefore encouraged the Republic of Srpska to consider introducing further measures to increase potential price reductions in generics. These include restricting more expensive generic esomeprazole and pantoprazole to second-line treatment or introducing prescribing targets for omeprazole and lanzoprazole.

Editor’s comment
Readers interested to learn more about enhancing prescribing efficiency in the Republic of Srpska are invited to visit www.gabi-journal.net to view the following manuscript published in GaBI Journal:

Ongoing initiatives in the Republic of Srpska to enhance prescribing efficiency; influence and future directions

If you are interested in contributing a research paper in a similar area to GaBI Journal, please send us your submission here.

Related article
Use of generic medicines in Ireland

Reference
1.  Godman B. Ongoing initiatives in the Republic of Srpska to enhance prescribing efficiency; influence and future directions. Generics and Biosimilars Initiative Journal (GaBI Journal). 2013;2(3):112-3. doi:10.5639/gabij.2013.0203.029

Permission granted to reproduce for personal and non-commercial use only. All other reproduction, copy or reprinting of all or part of any ‘Content’ found on this website is strictly prohibited without the prior consent of the publisher. Contact the publisher to obtain permission before redistributing.

Copyright – Unless otherwise stated all contents of this website are © 2013 Pro Pharma Communications International. All Rights Reserved.