Jpn Pharmacol Ther vol. 36 no Pharmacy Discounts on Generic Medicines in France: Is There Room for Further Efficiency Savings? Panos Kanavos

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1 Pharmacy Discounts on Generic Medicines in France: Is There Room for Further Efficiency Savings? Panos Kanavos a David Taylor b a LSE Health, London School of Economics and Political Science, UK b London School of Pharmacy, University of London, UK Kanavos PTaylor D. Pharmacy discounts on generic medicines in France: is there room for further efficiency savings? Current Medical Research and Opinion 2007; 23(10): ; 36(4): : Executive summary. In: Simoens S, Coster SD. Sustaining generic medicines markets in Europe. Leuven, Belgium: Katholieke Universiteit Leuven; p. 913.,.., AFSSAPS

2 35, 99 GE GE GE70, TV GE , 2, IMS 39IMS Health, MIDAS Kanavos

3 Abstract Background: reference pricinggeneric substitutioninternational nonproprietary name: INN Objectives: amplitude allowable discount Data and Method: net price n4n2 Results: wholesaler selling price: WSP exfactory price: EFP Conclusions: Organisation for Economic Cooperation and Development: OECD 1 generic healthcare system 2 3 4, 5 international nonproprietary name: INN 2 6 branded product 1065

4 wholesalerpharmacy : markup reimbursed pharmaceutical 3 exfactory price OCP Répartition52 margin drug bill number of generic pack substitution2003 offpatent pharmaceuticalreference pricing generic substitutionincentive amplitude offpatent product conceptual framework

5 policy implication principal agent theory 13 equivalent generic alternative INN financial incentiveregressive margin demandsidereimbursement ceiling supplyside distribution chain retail reimbursement volume discount principle3agent regressive margin 1 product homogeneity onward sales terms 2 fixed margin differential discount

6 (a)(b) 7 40molecule 11 (a) 19.3(b) (c) discounting practices distribution margin 12 exfactory price: EFP wholesaler selling price: WSP Price negotiation

7 OTC Zovirax ZelitrexViagra fixed discount1 2 nonreimbursed generic 4 INN 2 official price VAT EFP logistic commitment 1 commercial commitment 6030 Discounts on generic drug) Official Journal WSPEFP MinMax the Répertoire Génériquethe Guide des Équivalents Thérapeutiques 1069

8

9 patent protection branded originator product

10 acquisition price mg mg

11 824 1g mg mg putup best price Healthcare Finance Bill: PLFSS discounting practice 4 clawback system 1073

12 Dutreil Law Competition Directorate reallocation Merck FoundationProgramme on Pharmaceutical Policy Issues: PPPI Medical Technology Research Unit Philippe Sauvage French Ministry of Health Paul DeNijsCMRO 1074

13 References 1Mossialos E, Dixon A, Figueras J, Kutzin J,editors. Funding Health Care: Options for Europe. European Observatory on Health Care Systems. Buckingham: Open University Press; Simoens S, De Coster S. Sustaining Generic Medicines Markets in Europe. Research Centre for Pharmaceutical Care and Pharmaco-Economics. Catholic University of Leuven; Sandier S, Paris V, Polton D. Health care systems in transition: France. European Observatory on Health Systems and Policies; Available from: [Last accessed 8 November 2006] 4Kanavos P, Gemmill MG. Pharmaceutical Pricing and Reimbursement in Europe. London: Informa Publishing; Le Pen, C. Drug pricing and reimbursement in France. Pharmacoeconomics 1996;10(Suppl. 2): Le Pen C. Substitution générique et prescription dans le répertoire (Generic substitution and prescribing practices in the off-patent market). University of Paris-Dauphine: Paris; Comité économique des produits de santé (CEPS). Accord cadre entre le Comité économique des produits de santé et les entreprises du médicament pour la période Available from: contenu.htm [Last accessed 8 November 2006] 8Le Monde. Les pharmaciens, cible de choix des laboratoires,. Paris, 31 October, Kanavos P. Do generics offer significant savings to the UK NHS? Curr Med Res Opin 2006;23: Caves RE, Whinston ME, Hurwitz MA. Patent expiration, entry and competition in the United States pharmaceutical industry: an exploratory analysis. Brookings Papers on Economic Activity: Microeconomics Washington: Brookings Institute; 1991.p Grabowski H, Vernon J. Brand loyalty and price competition in pharmaceuticals after the 1984 Drug Act,, Journal of Law and Economics 1992;35: Garattini L, Ghislandi S. Off-patent drugs in Italy. A short sighted view? Eur J Health Econ 2006;7: Ricketts M. The economics of business enterprise: New approaches to the firm. Brighton: Wheatsheaf Books; Direction de la Recherche des Etudes de l, Evaluation et des Statistiques (DREES). Les Pharmaciens en France. Situation démographique et trajectoires professionnelles. Études et Résultats, Numéro 437, Octobre. Paris: Ministère de la Santé et des Solidarités;

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