The authors highlight that tendering, which involves the competitive bidding for the supply of pharmaceutical products, has gained popularity as a cost-containment strategy in healthcare systems. Specifically, tendering for generics and biosimilars aims to increase competition and drive down prices, ultimately reducing healthcare expenditure. 

Antoñanzas et al. emphasize that while tendering has the potential to achieve significant cost savings, it also poses several challenges. One of the main challenges is the potential for a decrease in product quality due to the focus on price competition. Lower prices may lead to manufacturers compromising on quality, which can have negative implications for patient safety and treatment effectiveness.

The authors also discuss the complex nature of generics and biosimilars, highlighting the importance of ensuring therapeutic equivalence and quality standards. Unlike generics, which are chemically identical to their reference products, biosimilars are highly similar but not identical to the reference biologics. Thus, ensuring efficacy, safety, and immunogenicity is crucial when considering biosimilars in tendering processes.

Furthermore, Antoñanzas et al. addresses the issue of market consolidation, where tendering may lead to a reduced number of suppliers. While consolidation can drive down prices, it can also result in limited market competition, potentially leading to monopolistic practices and reduced availability of pharmaceutical products.

The authors also discuss the potential impact of tendering on innovation. Tendering may incentivize manufacturers to prioritize price competitiveness over research and development investments. This could potentially hinder the introduction of innovative therapies and limit patient access to novel treatments. 

Furthermore, there is a need for careful consideration and evaluation of tendering processes. Healthcare policymakers should strike a balance between achieving cost savings and ensuring the availability, qualityand innovation of pharmaceutical products.

In conclusion, the authors underline the challenges associated with tendering for generics and biosimilars in healthcare purchasing policies. While tendering has the potential to drive down prices and reduce healthcare expenditure, it also raises concerns about product quality, market consolidation, and potential impacts on innovation. Policymakers must carefully navigate these challenges to implement tendering processes that maximize cost savings while maintaining patient safety, treatment effectiveness, and access to innovative therapies.

Related articles
Medicare drug price negotiation: implications 

Best-value biological selection making: more to consider than only price

Call for drug pricing transparency

Price controls, competition and tendering for biosimilars

Reference
1. Antoñanzas F, Juárez-Castelló C, Rodríguez-Ibeas R. Eur J Health Econ. 2023;24(4):485-7.

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