By Peter Kelly
The birth of generic medicines in the mid-1980s created a paradigm shift that revolutionised the National Health Service (NHS). Having finite resources is not a recent challenge so the introduction of generic medicines in the mid80s enabled the NHS to stretch their budgets further. The British Generic Manufacturers Association (BGMA) now estimate that generic prescribing saves the NHS around £13 billion a year.
It is fairly well-accepted that generic medicines offer savings for the NHS compared to the branded originator medicine; but they actually go beyond cost, having huge impact in creating greater access for patients to benefit from better therapeutic treatments.
Every year, branded medicines from originator companies lose their patent and the ensuing competition means these previously leading-edge treatments can now be accessed more affordably, which often leads to wider use. For example, when statin Zocor came off patent, clinicians were able to offer this medicine to more patients via generic simvastatin. Following this, Pfizer’s blockbuster Lipitor was available as generic atorvastatin meaning patients were able to benefit from the next generation statin – and that cycle continues as the next medical treatments lose their patent and become more accessible.
It is not only the lower price that enables more patients to access these generic medicines. When a branded medicine patent expires, rather than just the originator being the sole provider, it is now open for competition. As more generic medicine manufacturers come on board; it means an increased supply to the market that might not have been possible before. This creates a more robust supply chain which along with greater competition helps keep prices down.
Pharmacists play a key role in ensuring the UK generics medicine market works.
Let me explain how. In general, once a branded originator medicine loses its patent and becomes generic – the price drops by 70 per cent within the first six months, falling to 80-90 per cent lower over a four-year period. In my experience, that drop to 90 per cent frequently happens much faster, often only weeks after the initial 70 per cent drop. These steep drops in price can in part be contributed to pharmacists being incentivised by a retained buying margin resulting in cost-effective purchasing. This, in turn, drives generic medicine manufacturers to lower their prices.
When generic medicines were first introduced there was some initial scepticism around the science and whether these ‘copies’ were as effective as the original. Those misconceptions were quickly overcome with healthcare professionals now fully understanding the vital role played by generic medicines. Whilst healthcare professionals understand and value generic medicines there is still some way to go in changing the mindset of patients. This can be particularly tricky when a switch to the generic version of their medication first occurs. Again, the dispensing pharmacist plays a key role at helping to allay any concerns and reassure the patient.
Due to the UK system being set up to encourage generic prescribing and dispensing, the UK now sees an average of 1.2 billion packs of generic medicines dispensed a year with these on average being reimbursed at around £2.50 per pack. These increased volumes, combined with more complex medicines becoming available, has meant technology has had to evolve rapidly to keep up. It has become vital that manufacturers, like Accord,find new ways to develop and launch these complex medicines as well as continuing to provide the high volume key treatments all whilst maintaining high quality and service.
The landscape is forever changing – the lines between traditional pharma and generic medicine manufacturers are blurring and pharmacists may find themselves managing patients that would normally be treated in a secondary care setting.
This is in part due to many generic manufacturers, like Accord moving away from the traditional generic medicines model of the past by thinking differently and investing in R&D focused on delivering improvements over standard medicines, such as new therapeutic uses or a different mode of administration. For example, changing a syringe to a self-inject device so that the product can potentially be used at home by the patient rather than only in hospital.
Innovations such as these not only have the potential to improve quality of life for patients, but by empowering the patient they can also unlock significant cost savings for the NHS.
Peter Kelly is Managing Director of Accord UK.
This article also appears in the October issue of Pharmacy Business.