Cardiovascular diseases are the primary cause of mortality worldwide [1-3], accounting for over 30% of all deaths. However, in the last few decades, the number of deaths attributed to cardiovascular diseases in higher-income countries has been on the decline. This is thought to be largely due to improved and increased healthcare interventions, according to Gama et al. [4].
This high-income trend is reflected in Portugal, where the uptake of generics has been promoted in recent years. Increased use of generics and essential medicines can lead to a reduction in overall expenditure on medicines. Researchers Gama et al. from the University of Porto Medical School, Portugal have looked at the recent uptake of generic and essential medicines in Portugal and estimated the potential for cost reduction by increasing their use [4].
Data from the Pharmacy Sales Information System of the Centre for Health Evaluation & Research (Centro de Estudos e Avaliação em Saúde, CEFAR) of the Portuguese National Association of Pharmacies’ national database enabled the team to gain an understanding of the overall consumption of medicines for the prevention and treatment of cardiovascular diseases in Portugal between 2004−2012. Overall, there was a 50% increase in medicines used, with an accompanying substantial increase in the proportion of generics and essential medicines. However, during this time there was an overall decrease in the cost of these medicines from an overall high of Euros 1,096 million in 2006, to just Euros 753 million in 2012. This can be attributed to the increased use of generic and essential medicines.
In addition, the 40 most used medicine groups accounted for over 80% of overall cardiovascular medicines consumption in 2012. Here, generics were available for many of the top 40 medicines, and some were classified as essential medicines. Some of the top 40 medicines were also fixed-dose medicines that can be replaced by a combination of less-costly essential medicines. In light of this, the team estimated that the increased in use of generics and essential medicines, in place of the top 40 medicines, would have contributed to a saving of Euros 275 million. This is over a third of Portugal’s total expenditure on cardiovascular medicines.
This Gama et al. study has revealed that, although Portugal has made headway in increasing the uptake of generic and essential medicines, further improvements can be made. Money is already being saved, but further healthcare funds could be made available if there is increased use of generic and essential medicines and a more rational use of fixed-dose combinations. The patterns of medicines consumption and expenditure should continue to be monitored to ensure effective planning of healthcare resources.
Conflict of interest
Authors of the research paper [4]were employed at the Centre for Health Evaluation & Research (CEFAR) of the National Association of Pharmacies (ANF) when the study was conducted, and have no conflict of interest to declare.
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References
1. World Health Organization. Kaplan W, Mathers C. The world medicines situation 2011. Global health trends: global burden of disease and pharmaceutical needs [homepage on the Internet]. [cited 2018 Mar 23]. Available from: http://apps.who.int/medicinedocs/documents/s20036en/s20036en.pdf
2. World Health Organization. Kaplan W, Wirtz VJ, Mantel-Teeuwisse A, Stolk P, Duthey B, Laing R. Priority medicines for Europe and the world - 2013 update [homepage on the Internet]. [cited 2018 Mar 23]. Available from: http://www.who.int/medicines/areas/priority_medicines/en/
3. European Society of Cardiology. Nichols M, Townsend N, Scarborough P, Rayner M. 2012 European cardiovascular disease statistics [homepage on the Internet]. [cited 2018 Mar 23]. Available from: https://www.escardio.org/The-ESC/What-we-do/Initiatives/EuroHeart/2012-European-Cardiovascular-Disease-Statistics
4. Gama H, Torre C , Guerreiro J-P , Azevedo A, Costa S, Lunet N. Use of generic and essential medicines for prevention and treatment of cardiovascular diseases in Portugal. BMC Health Services Research. 2017;17:449. doi:10.1186/s12913-017-2401-2.
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