OBJECTIVES: To primarily document the influence of recent changes in the pricing policies for generics and originators in Norway, coupled with prescribing restrictions for both the proton pump inhibitors (PPIs) and statins, on subsequent prescribing efficiency, to provide possible examples to other countries. Second, to review the impact of prescribing restrictions on ezetimibe utilization in Norway compared with other European countries, again to provide guidance. METHODS: A retrospective observational study using data from the Norwegian Drug Wholesales Statistics to evaluate changes in utilization patterns for the PPIs and statins from 2001 to 2009, and the Norwegian Prescription Database for expenditure data from January 2004 to 2009. Reforms validated with key personnel at the Norwegian Medicines Agency. RESULTS: Atorvastatin utilization as measured by defined daily doses decreased after prescribing restrictions. This, coupled with increased utilization of generic simvastatin at only 15% of prepatent loss prices in recent years, led to a 55% decrease in statin expenditure in Norway between 2004 and 2009 despite appreciably increased utilization. Utilization of esomeprazole also fell following prescribing restrictions, but to a lesser extent. This reduction, coupled with low prices for generics as a result of recent pricing policies, resulted in PPI expenditure decreasing by 27% during the same period despite again appreciably increased utilization. CONCLUSIONS: Policies to reduce the price of generics have been successfully introduced in Norway despite its small population size versus a number of other Western European countries. Prescribing restrictions have also been successfully introduced, mirroring the influence with multifaceted reforms in other European countries. The same applies to ezetimibe with utilization at only 1.9% of total statin and ezetimibe utilization in 2009. However, the difference in subsequent utilization patterns for atorvastatin versus esomeprazole makes it a challenge for health authorities to predict the ultimate impact of such measures. This requires further research.
OBJECTIVES: To primarily document the influence of recent changes in the pricing policies for generics and originators in Norway, coupled with prescribing restrictions for both the proton pump inhibitors (PPIs) and statins, on subsequent prescribing efficiency, to provide possible examples to other countries. Second, to review the impact of prescribing restrictions on ezetimibe utilization in Norway compared with other European countries, again to provide guidance. METHODS: A retrospective observational study using data from the Norwegian Drug Wholesales Statistics to evaluate changes in utilization patterns for the PPIs and statins from 2001 to 2009, and the Norwegian Prescription Database for expenditure data from January 2004 to 2009. Reforms validated with key personnel at the Norwegian Medicines Agency. RESULTS:Atorvastatin utilization as measured by defined daily doses decreased after prescribing restrictions. This, coupled with increased utilization of generic simvastatin at only 15% of prepatent loss prices in recent years, led to a 55% decrease in statin expenditure in Norway between 2004 and 2009 despite appreciably increased utilization. Utilization of esomeprazole also fell following prescribing restrictions, but to a lesser extent. This reduction, coupled with low prices for generics as a result of recent pricing policies, resulted in PPI expenditure decreasing by 27% during the same period despite again appreciably increased utilization. CONCLUSIONS: Policies to reduce the price of generics have been successfully introduced in Norway despite its small population size versus a number of other Western European countries. Prescribing restrictions have also been successfully introduced, mirroring the influence with multifaceted reforms in other European countries. The same applies to ezetimibe with utilization at only 1.9% of total statin and ezetimibe utilization in 2009. However, the difference in subsequent utilization patterns for atorvastatin versus esomeprazole makes it a challenge for health authorities to predict the ultimate impact of such measures. This requires further research.
Authors: Brian Godman; Bjorn Wettermark; Menno van Woerkom; Jessica Fraeyman; Samantha Alvarez-Madrazo; Christian Berg; Iain Bishop; Anna Bucsics; Stephen Campbell; Alexander E Finlayson; Jurij Fürst; Kristina Garuoliene; Harald Herholz; Marija Kalaba; Ott Laius; Jutta Piessnegger; Catherine Sermet; Ulrich Schwabe; Vera V Vlahović-Palčevski; Vanda Markovic-Pekovic; Luka Vončina; Kamila Malinowska; Corinne Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2014-06-17 Impact factor: 5.810
Authors: Brian Godman; Anna Bucsics; Thomas Burkhardt; Jutta Piessnegger; Manuela Schmitzer; Corrado Barbui; Emanuel Raschi; Marion Bennie; Lars L Gustafsson Journal: Front Pharmacol Date: 2013-01-07 Impact factor: 5.810
Authors: Rickard E Malmström; Brian B Godman; Eduard Diogene; Christoph Baumgärtel; Marion Bennie; Iain Bishop; Anna Brzezinska; Anna Bucsics; Stephen Campbell; Alessandra Ferrario; Alexander E Finlayson; Jurij Fürst; Kristina Garuoliene; Miguel Gomes; Iñaki Gutiérrez-Ibarluzea; Alan Haycox; Krystyna Hviding; Harald Herholz; Mikael Hoffmann; Saira Jan; Jan Jones; Roberta Joppi; Marija Kalaba; Christina Kvalheim; Ott Laius; Irene Langner; Julie Lonsdale; Sven-Äke Lööv; Kamila Malinowska; Laura McCullagh; Ken Paterson; Vanda Markovic-Pekovic; Andrew Martin; Jutta Piessnegger; Gisbert Selke; Catherine Sermet; Steven Simoens; Cankat Tulunay; Dominik Tomek; Luka Vončina; Vera Vlahovic-Palcevski; Janet Wale; Michael Wilcock; Magdalena Wladysiuk; Menno van Woerkom; Corrine Zara; Lars L Gustafsson Journal: Front Pharmacol Date: 2013-05-14 Impact factor: 5.810