Pricing of oral generic cancer medicines in 25 European countries; findings and implications

Godman, Brian and Hill, Andrew and Simoens, Steven and Kurdi, Amanj and Gulbinovič, Jolanta and Martin, Antony and Timoney, Angela and Gotham, Dzintars and Wale, Janet and Bochenek, Tomasz and Rothe, Celia and Hoxha, Iris and Malaj, Admir and Hierländer, Christian and Sauermann, Robert and Hamelinck, Wouter and Mitkova, Zornitza and Petrova, Guenka and Laius, Ott and Sermet, Catherine and Langer, Irene and Selke, Gisbert and Yfantopoulos, John and Joppi, Roberta and Jakupi, Arianit and Poplavska, Elita and Greiciute-Kuprijanov, Ieva and Vella Bonanno, Patricia and Piepenbrink, JF and de Valk, Vincent and Hagen, Carolin and Ringerud, Anne Marthe and Plisko, Robert and Wladysiuk, Magdalene and Marković-Peković, Vanda and Grubiša, Nataša and Mardare, Ileana and Novakovic, Tanja and Ponorac, Tatjana and Parker, Mark and Fürst, Jurij and Tomek, Dominic and Cortadellas, Mercè Obach and Zara, Corrine and Juhasz-Haverinen, Maria and Skiold, Peter and McTaggart, Stuart and Haycox, Alan (2019) Pricing of oral generic cancer medicines in 25 European countries; findings and implications. Generics and Biosimilars Initiative journal. ISSN 2033-6403 (In Press)

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    Abstract

    Introduction: There are appreciable concerns among European health authorities with growing expenditure on cancer medicines and issues of sustainability. The enhanced use of low cost generics could help. Aims: Consequently, there is a need to comprehensively document current and future arrangements regarding the pricing of generic cancer medicines across Europe, and whether these are indication specific, as well as how this translates into actual prices to provide future direction. Methodology: Mixed method approach with qualitative research among senior health authority personnel and their advisers. Quantitative research via health authority databases to ascertain current prices for oral cancer medicines that had lost their patent and the influence of population size and economics on prices. Results: 25 European countries participated. Currently we see (a) variable approaches to the pricing of generic cancer medicines, which will continue; (b) no concerns with substitution for oral generic cancer medicines; (c) substantial price reductions versus originators for generic capecitabine (up to -93.1%), generic imatinib (up to -97.8%) and generic temozolomide (up to -80.7%). Prices for oncology medicines are not indication specific, and are not affected by population size although influenced by pricing approaches. There have also been price increases for some non-patented cancer medicines following manufacturer changes although now stabilising. Conclusion: The considerable price reductions seen for some generics means health authorities should further encourage the use of generic oncology medicines when they become available to fund increased volumes and new valued cancer medicines. Countries are also starting to address price increases for generics following changes in the manufacturer