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Competition in the off-patent medicine market in Spain: The national reference pricing system versus the regional system of tendering for outpatient prescription medicines in Andalusia

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  • Casanova-Juanes, Julieta
  • Mestre-Ferrandiz, Jorge
  • Espín-Balbino, Jaime

Abstract

Spain has a reference price system (RPS) for off-patent medicines since 1997. In addition, from 2012, Andalusia is running a series of tenders for procuring off-patent medicines dispensed by community pharmacies, for those medicines included in the system of homogenous clusters within the national reference price system. Such tenders offer additional savings to the regional payer – in the form of rebates (“economic improvements”) from companies winning the tender. This paper estimates that the regional savings were between €43 M to €54 M over the period of study (April – September 2015). The paper also estimates that Spain could have made between 14 and 17 times higher savings than the national reference pricing system savings, had the Andalusian-type tender been implemented at national level over the same period of study. Based on our analysis, we have four remarks. First, the national RPS in Spain is not generating enough price competition for off-patent products dispensed in primary care pharmacies. Second, tenders can be a useful way to generate competition and financial savings in the off-patent market. Third, tenders can lead to discounts offered by medicine providers being redistributed from pharmacies to payers. And fourth, before implementing a national tender in Spain, several key issues need to be addressed to ensure it provides the right incentives both in the short and long run.

Suggested Citation

  • Casanova-Juanes, Julieta & Mestre-Ferrandiz, Jorge & Espín-Balbino, Jaime, 2018. "Competition in the off-patent medicine market in Spain: The national reference pricing system versus the regional system of tendering for outpatient prescription medicines in Andalusia," Health Policy, Elsevier, vol. 122(12), pages 1310-1315.
    • Handle: RePEc:eee:hepoli:v:122:y:2018:i:12:p:1310-1315
    DOI: 10.1016/j.healthpol.2018.10.008
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    References listed on IDEAS

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    1. Dylst, Pieter & Vulto, Arnold & Simoens, Steven, 2011. "Tendering for outpatient prescription pharmaceuticals: What can be learned from current practices in Europe?," Health Policy, Elsevier, vol. 101(2), pages 146-152, July.
    2. Sotiris Vandoros, 2014. "Therapeutic Substitution Post‐Patent Expiry: The Cases Of Ace Inhibitors And Proton Pump Inhibitors," Health Economics, John Wiley & Sons, Ltd., vol. 23(5), pages 621-630, May.
    3. Jon Sussex & Adrian Towse & Nancy Devlin, 2013. "Operationalizing Value-Based Pricing of Medicines," PharmacoEconomics, Springer, vol. 31(1), pages 1-10, January.
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    1. Qian Xing & Wenxi Tang & Mingyang Li & Shuailong Li, 2022. "Has the Volume-Based Drug Purchasing Approach Achieved Equilibrium among Various Stakeholders? Evidence from China," IJERPH, MDPI, vol. 19(7), pages 1-22, April.
    2. Fernando Antoñanzas & Carmelo Juárez-Castelló & Roberto Rodríguez-Ibeas, 2023. "Tenders for generics and biosimilars: a challenging purchasing policy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(4), pages 485-487, June.
    3. Christensen, Elisabeth & Hirsch, Niels Christian & Andersen, Jonas Valbjørn & Ehlers, Lars Holger, 2022. "The analogue substitution model: Introducing competition in the absence of generic substitution in Danish hospitals," Health Policy, Elsevier, vol. 126(9), pages 844-852.
    4. Sabine Vogler & Guillaume Dedet & Hanne Bak Pedersen, 2019. "Financial Burden of Prescribed Medicines Included in Outpatient Benefits Package Schemes: Comparative Analysis of Co-Payments for Reimbursable Medicines in European Countries," Applied Health Economics and Health Policy, Springer, vol. 17(6), pages 803-816, December.

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