International Generic Availability Improvements between 2010 and 2021

OBJECTIVES: Although expensive new medicines occupy much policy attention, older and less expensive generic drugs make up the majority of drugs used internationally and are vital to population health. This research aims to rank a group of countries with similar pharmaceutical environments on their generic drug market’s vitality.

METHODS: We use oral solid drug sales data from IQVIA’s MIDAS database and population data from the OECD for the period 2010-2021. We investigate trends in the distribution of medicines sold by number of available generics, the number of companies selling generics, generic sales per capita, and bilateral price ratios. We compare the generic markets of the United States, Australia, Belgium, Canada, France, Germany, Italy, Japan, Netherlands, Norway, Spain, Sweden, and the United Kingdom.

RESULTS: While the countries investigated showed important variance in all metrics, international generic availability and competition indicators considerably improved since 2010. In 2021, the median country sold generics for 73% of the oral solids on its market, a 12-pp increase from 2010. Similarly, the median country saw a rise of 10 pp in the proportion of oral solids with competing generics between 2010 and 2021, which increased from 44% to 54%. The US led other countries in most metrics, including the number of competing manufacturers selling generics (N=251 in 2021), the number of generic medicines sold (N=12,851), and the proportion of medicines with competing generics (78%), while Canada had the highest generic spending per capita (US$ 109). Smaller countries tended to rank lower in most metrics.

CONCLUSIONS: Availability and competition in international generic markets have markedly improved between 2010 and 2021. For most metrics, the US ranks favorably relative to other countries, showing greater than median generic availability, competition, and sales.