OBJECTIVES:  The objective of generic drug policies in most countries is defined from a disinvestment perspective: reduction in expenditures without compromising health outcomes. However, in countries with restricted access of patients to original patented drugs, the objective of generic drug policies can also be defined from an investment perspective: health gain by improved patient access without need for additional health budget. The objective of this study was to assess whether generic clopidogrel entry reduced the role of affordability constraints and increased clopidogrel utilization in European countries. METHODS:  We analyzed the determinants of clopidogrel utilization in Europe between 2004 and 2014 using hierarchical linear models on country-level longitudinal data. The first generic clopidogrel entry occurred in 2009 in the majority of countries. RESULTS:  Clopidogrel utilization was strongly affected by affordability constraints (as proxied by GDP per capita) before entrance of generic medicines, but this effect decayed by 2014. Our estimated hierarchical linear models found a substantially larger trend increase of clopidogrel utilization in lower-income European countries than in the higher-income ones. Similarly, generic entry increased clopidogrel consumption in lower-income countries but did not have an effect in the highest-income ones. The models also suggest that an earlier generic entry was associated with a larger effect. CONCLUSIONS:  The case of clopidogrel indicates that the entrance of generics may increase patient access to effective medicines, most notably in lower-income countries, thereby reducing inequalities between European patients. Policymakers should also consider this investment aspect of generic medicines when designing international and national pharmaceutical policies.