OBJECTIVES: Prescription switching unnecessarily towards newer expensive medicines is considered a significant factor for the increase of the public pharmaceutical expenditure in Greece. Although prescription control is considered as a main policy goal, the relevant measures, including restrictive protocols, prescription monitoring, and incentives for the use of affordable therapeutic alternatives mark significant delay. The purpose of this study is to quantify the economic impact of switching generics towards on-patent medicines at the public outpatient setting in Greece for 2017.

METHODS: Data from the December 2016 and July 2017 official price bulletins, and the respective positive reimbursement lists were used combined with volume data from IQVIA database with the assumption that reimbursed market data are proportional to the retail market data. Reimbursement prices prior to compulsory paybacks were used. All volume data were normalized to standard units. ATC codes were assigned to the respective ICD codes to create a coherent mapping of the disease-treatment relation. Therapeutic categories with generics were used in the analysis. Switching dynamics between generics and on patent medicines were identified by analyzing the evolution of volume data, during the study period.

RESULTS: Switching generics towards on-patents already present in the positive list prior to 2017, increased the relevant cost by a factor of 3.72 while switching towards new on-patents introduced to the positive list in 2017 increased the relevant cost by a factor of 7.84.

CONCLUSIONS: Switching towards newer medicines partially explains the increase of the public pharmaceutical expenditure in Greece. Our study is the first to quantify this trend in a standard –unit basis. In view of the restrictive public pharmaceutical budget, the study findings call for further measures to rationalize medical prescription and use, ensuring the viability of the healthcare system.