Generic Substitution

A cross-sectional postal survey was conducted among pharmaceutical companies with an office in Finland and substitutable medicines in the Finish pharmaceutical market one year (2005) and five years (2009) after the introduction of GS. Completed questionnaires were returned by 16 original and 8 generic product companies in 2005 (response rate 56%, n = 41) and by 16 original and 6 generic product companies in 2009 (response rate 56%, n = 39). Descriptive statistical analyses were performed. Mandatory generic substitution (GS) was introduced in Finland on 1 April 2003. The aim of this study was to explore and compare the impacts of GS on the activities of pharmaceutical companies representing mainly original or generic pharmaceutical products in Finland. The self-reported impact of GS from pharmaceutical companies' perspective was explored with a focus on the number of employees, the range of sales packages on the market, the marketing activities, the research and development of new pharmaceutical products and storage of pharmaceuticals.
Conclusions.
The number of employees (2004: n = 6/16, 2008: n = 7/16) and the amount of prescription medicine marketing (2004: n = 7/16, 2008: n = 8/16) decreased in many of the original product companies after the introduction of GS. GS resulted in problems related to the storage of pharmaceuticals in the original product companies shortly after GS was introduced (p = 0.032 between 2004 and 2008). In the generic product companies, the prescription medicine representatives' visits to pharmacies increased at the beginning of GS (p = 0.021 between 2004 and 2008). In addition, GS caused problems with the storage of pharmaceuticals one year and five years after the reform (2004: n = 4/7, 2008: n = 3/6). The differences between original and generic product companies regarding the impacts of GS were not, however, statistically significant. GS did not affect on the range of sales packages on the market or the research activities of the majority of companies.

Poly Pharmacy Analysis.

To the benefit of pharmacy: By applying individual-based data on dispensed drugs, we have studied all dispensed prescribed drugs for the entire Swedish population during four 3-month periods 2005-2008. Five or more (DP [greater than or equal to]5) and ten or more (DP [greater than or equal to]10) dispensed drugs during the 3-month period was applied as the cut-offs indicating the existence of poly pharmacy and excessive poly pharmacy respectively. An increase in the use of drugs and poly pharmacy have been displayed over time in spite of the fact that poly pharmacy represents a well known risk factor as regards patients' health due to the adverse drug reactions, drug-drug interactions, and low adherence to drug therapy arising from poly pharmacy. For policymakers, as well as for clinicians, it is important to follow the developing trends in drug use and poly pharmacy over time. We wanted to study if the prevalence of poly pharmacy in an entire national population has changed during a 4-year period.
Conclusions.
Finally, the mean number of dispensed drugs per individual increased by 3.6% (from 3.3 to 3.4) during the study period During the period 2005-2008, the prevalence of poly pharmacy (DP[greater than or equal to]5) increased by 8.2% (from 0.102 to 0.111), and the prevalence of excessive poly pharmacy (DP[greater than or equal to]10) increased by 15.7% (from 0.021 to 0.024). In terms of age groups, the prevalence of poly pharmacy and excessive poly pharmacy increased as regards all ages with the exception of the age group 0-9 years. However, the prevalence of excessive poly pharmacy displayed a clear age trend, with the largest increase for the groups 70 years and above. Furthermore, the increase in the prevalence of poly pharmacy was, generally, approximately twice as high for men as for women.