Analysis of Spanish generic medicines retail market: recommendations to enhance long-term sustainability

Abstract

The use of generic medicines in Spain is traditionally low compared to other European countries, despite efforts of the Spanish government in the past. This paper provides a perspective on the Spanish generic medicines retail market and how the current policy environment may affect the long-term sustainability. The Spanish government’s focus on prices of generic medicines (e.g., mandatory price cuts, reference price set at the lowest level) have made them amongst the lowest in Europe. In our opinion, this combination of continuous pressure on prices and limited diffusion of generic medicines may undermine the long-term sustainability of the Spanish generic medicines retail market. The unique experience in Spain shows the impact of demand-side policies on the use of generic medicines. Because a sustainable generic medicines retail market is important to maintain future competition in the off-patent medicines market, this perspective paper rounds off with recommendations to increase its sustainability.

Keywords::

• demand-side policies
• generic medicines
• pharmaceuticals
• pricing
• reimbursement
• Spain
• sustainability

Acknowledgements

The authors are grateful to professor Jaime Espin and Mrs. Piedad Ferré for critically reviewing the manuscript.

Financial & competing interests disclosure

S Simoens holds the EGA Chair “European policy towards generic medicines”. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The use of generic medicines in Spain has been traditionally low compared with other European countries.

• This article aims to provide a perspective on the Spanish generic medicines retail market and how the current policy environment may affect the long-term sustainability.

• The Spanish government is in control of market access, pricing and reimbursement decisions of pharmaceuticals (i.e., supply side) while the ACs in Spain are responsible for their own pharmaceutical policy (i.e., demand side).

• The Spanish government’s focus on the price level of generic medicines in the past has made them among the lowest in Europe. Price differences between originator and generic medicines have been eroded by the current reference pricing system in most reference groups and have thereby eliminated generic medicines’ main advantage.

• The continuous pressure on prices in combination with the limited diffusion of generic medicines in Spain may threaten the long-term sustainability of the Spanish generic medicines market.

• The importance of demand-side policies on the use of generic medicines is demonstrated by the differing generic market shares between the ACs.

• The Spanish government must take action to ensure the long-term sustainability of the Spanish generic medicines retail market. Recommendations to increase this sustainability are suggested at the end of this perspective paper.

Notes