Potential Savings in Prescription Drug Costs for Hypertension, Hyperlipidemia, and Diabetes Mellitus by Equivalent Drug Substitution in Austria: A Nationwide Cohort Study

Applied Health Economics and Health Policy

Volumn 13, Issue 2, 2015, Pages 193-205

  Heinze, Georg ^a   Hronsky, Milan ^a   Reichardt, Berthold ^b   Baumgärtel, Christoph ^c   Müllner, Marcus ^c,d   Bucsics, Anna ^e,f   Winkelmayer, Wolfgang C ^g,h  

^a MEDICAL UNIVERSITY OF VIENNA   (Austria)

^b Burgenland Regional Health Insurance Fund   (Austria)

^c AUSTRIAN AGENCY FOR HEALTH AND FOOD SAFETY   (Austria)

^d PERI Consulting GmbH   (Austria)

^e Main Assoc of Austrian Social Security Institutions   (Austria)

^f UNIVERSITY OF VIENNA   (Austria)

^g STANFORD UNIVERSITY SCHOOL OF MEDICINE   (United States)

^h BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDIABETIC AGENT; ANTIHYPERTENSIVE AGENT; ANTILIPEMIC AGENT; GENERIC DRUG;

AUSTRIA; COST; COST CONTROL; DIABETES MELLITUS; DRUG COST; ECONOMICS; HUMAN; HYPERLIPIDEMIAS; HYPERTENSION; STATISTICS AND NUMERICAL DATA;

ANTIHYPERTENSIVE AGENTS; AUSTRIA; COST CONTROL; COST SAVINGS; COSTS AND COST ANALYSIS; DIABETES MELLITUS; DRUG COSTS; DRUGS, GENERIC; HUMANS; HYPERLIPIDEMIAS; HYPERTENSION; HYPOGLYCEMIC AGENTS; HYPOLIPIDEMIC AGENTS;

EID: 84939994684     PISSN: 11755652     EISSN: 11791896     Source Type: Journal    
DOI: 10.1007/s40258-014-0143-4     Document Type: Article

References (50)

1. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 2: health outcomes and satisfaction with care. Ann Intern Med. 2003;138:288–98.
2. Welch HG, Sharp SM, Gottlieb DJ, Skinner JS, Wennberg JE. Geographic variation in diagnosis frequency and risk of death among Medicare beneficiaries. J Am Med Assoc. 2011;305:1113–8.
3. Donohue JM, Morden NE, Gellad WF, Bynum JP, Zhou W, Hanlon JT, et al. Sources of regional variation in Medicare Part D drug spending. N Engl J Med. 2012;366:530–8.
4. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med. 2003;138:273–87.
5. Fretheim A, Oxman AD. International variation in prescribing antihypertensive drugs: its extent and possible explanations. BMC Health Serv Res. 2005;5:21.
6. Sturm HB, van Gilst WH, Veeger N, Haaijer-Ruskamp FM. Prescribing for chronic heart failure in Europe: does the country make the difference? A European survey. Pharmacoepidemiol Drug Saf. 2007;16:96–103.
7. Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. The role of cost-effectiveness analysis in health and medicine. Panel on Cost-Effectiveness in Health and Medicine. J Am Med Assoc. 1996;276:1172–7.
8. Furberg CD, Herrington DM, Psaty BM. Are drugs within a class interchangeable? Lancet. 1999;354:1202–4.
9. European Medicines Agency. Guideline on the investigation of bioequivalence. CPMP/EWP/QWP/1401/98 Rev. 1/Corr. London: European Medicines Agency; 20 Jan 2010.
10. Kesselheim AS, Misono AS, Lee JL, Stedman MR, Brookhart MA, Choudry MK, et al. Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysis. JAMA. 2008;300(21):2514–26. doi:10.1001/jama.2008.758.
11. Leopold C, Vogler S, Piessnegger J, Bucsics A. Aktuelle Heilmittelausgaben und arzneimittelpolitische Trends in Europa. Soziale Sicherheit. 2013;9:414–29.
12. Godman B, Wettermark B, van Woerkom M, Fraeyman J, Alvarez-Madrazo S, Berg C, et al. Multiple policies to enhance prescribing efficiency for established medicines in Europe with a particular focus on demand-side measures: findings and future implications. Front Pharmacol. 2014;5:106.
13. WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment 2012. Oslo: WHO; 2011.
14. Hauptverband der österreichischen Sozialversicherungsträger [in German]. http://www.hauptverband.at/portal27/portal/hvbportal/emed/. Accessed 13 Oct 2014.
15. PostgreSQL, the world’s most advanced open-source database. http://www.postgresql.org. Accessed 24 Jul 2014.
16. R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria, 2014. http://www.R-project.org/. Accessed 24 Jul 2014.
17. Guidelines for good pharmacoepidemiologic practices (GPP). Pharmacoepidemiol Drug Saf. 2008;17:200–208. http://www.pharmacoepi.org/resources/guidelines_08027.cfm. Accessed 24 Jul 2014.
18. Godman B, Bucsics A, Burkhardt T, Haycox A, Seyfried H, Weininger P. Insight into recent reforms and initiatives in Austria: implications for key stakeholders. Expert Rev Pharmacoecon Outcomes Res. 2008;8:357–71.
19. Statistik Austria. Bruttojahreseinkommen der ganzjährig Vollzeitbeschäftigten 2012. Vienna, 2013. http://www.statistik.at/web_de/statistiken/soziales/personen-einkommen/jaehrliche_personen_einkommen/074884.html. Accessed 11 Jul 2014.
20. Wanek-Zajic B, Holzfeind E. Arbeitsmarktlage 2012. AMS Österreich, Vienna, 2013. http://www.ams.at/_docs/001_jb2012.pdf. Accessed 11 Jul 2014.
21. Godman B, Shrank W, Andersen M, Berg C, Bishop I, Burkhardt T, et al. Comparing policies to enhance prescribing efficiency in Europe through increasing generic utilization: changes seen and global implications. Expert Rev Pharmacoecon Outcomes Res. 2010;10(6):707–22.
22. Andersson K, Bergstrom G, Petzold MG, Carlsten A. Impact of a generic substitution reform on patients’ and society’s expenditure for pharmaceuticals. Health Policy. 2007;81:376–84.
23. Fischer MA, Schneeweiss S, Avorn J, Solomon DH. Medicaid prior-authorization programs and the use of cyclooxygenase-2 inhibitors. N Engl J Med. 2004;351:2187–94.
24. Bucsics A, Godman B, Burkhardt T, Schmitzer M, Malmström RE. Influence of lifting prescribing restrictions for losartan on subsequent sartan utilization patterns in Austria: implications for other countries. Expert Rev Pharmacoecon Outcomes Res. 2012;12:809–19.
25. Godman B, Burkhardt T, Bucsics A, Wettermark B, Wieninger P. Impact of recent reforms in Austria on utilization and expenditure of PPIs and lipid-lowering drugs: implications for the future. Expert Rev Pharmacoecon Outcomes Res. 2009;9:475–84. doi:10.1586/ERP.09.43.
26. Vogler S, Zimmermann N. How do regional sickness funds encourage more rational use of medicines, including the increase of generic uptake? A case study from Austria. GaBi J. 2013;2:65–75.
27. Gilman BH, Kautter J. Impact of multitiered copayments on the use and cost of prescription drugs among Medicare beneficiaries. Health Serv Res. 2008;43:478–95.
28. Schneeweiss S, Soumerai SB, Maclure M. Reference drug pricing. Can Med Assoc J. 2002;167:126–7 (author reply 127–128).
29. Vogler S. The impact of pharmaceutical pricing and reimbursement policies on generics uptake: implementation of policy options on generics in 29 European countries—an overview. GaBi J. 2012;1:93–100. doi:10.5639/gabij.2012.0102.020.
30. Leopold C, Vogler S, Mantel-Teeuwisse AK, de Joncheere K, Leufkens HG, Laing R. Differences in external price referencing in Europe: a descriptive overview. Health Policy. 2012;104:50–60. doi:10.1016/j.healthpol.2011.09.008.
31. Fischer MA, Avorn J. Economic implications of evidence-based prescribing for hypertension: can better care cost less? J Am Med Assoc. 2004;291:1850–6.
32. Usher-Smith J, Ramsbottom T, Pearmain H, Kirby M. Evaluation of the clinical outcomes of switching patients from atorvastatin to simvastatin and losartan to candesartan in a primary care setting: 2 years on. Int J Clin Pract. 2008;62:480–4. doi:10.1111/j.1742-1241.2007.01690.x.
33. Sakshaug S, Furu K, Karlstad O, Ronning M, Skurtveit S. Switching statins in Norway after new reimbursement policy: a nationwide prescription study. Br J Clin Pharmacol. 2007;64:476–81. doi:10.1111/j.1365-2125.2007.02907.x.
34. Martin A, Godman B, Miranda J, Tilstone J, Saleem N, Olsson E, et al. Measures to improve angiotensin receptor blocker prescribing efficiency in the UK: findings and implications. J Compe Eff Res. 2014;3:41–51. doi:10.2217/cer.13.83.
35. Shrank WH, Choudhry NK, Agnew-Blais J, Federman AD, Liberman JN, Liu J, et al. State generic substitution laws can lower drug outlays under Medicaid. Health Aff. 2010;29:1383–90.
36. Schneeweiss S, Walker AM, Glynn RJ, Maclure M, Dormuth C, Soumerai SB. Outcomes of reference pricing for angiotensin-converting-enzyme inhibitors. N Engl J Med. 2002;346:822–9.
37. Schneeweiss S, Soumerai SB, Glynn RJ, Maclure M, Dormuth C, Walker AM. Impact of reference-based pricing for angiotensin-converting enzyme inhibitors on drug utilization. Can Med Assoc J. 2002;166:737–45.
38. Schneeweiss S, Dormuth C, Grootendorst P, Soumerai SB, Maclure M. Net health plan savings from reference pricing for angiotensin-converting enzyme inhibitors in elderly British Columbia residents. Med Care. 2004;42:653–60.
39. Duerden MG, Hughes DA. Generic and therapeutic substitions in the UK: are they a good thing? Br JClin Pharmacol. 2010;70:335–41. doi:10.111/j.1365-2125.2010.03718.x.
40. Godman B, Bishop I, Finlayson AE, Campbell S, Kwon HY, Bennie M. Reforms and initiatives in Scotland in recent years to encourage the prescribing of generic drugs, their influence and implications for other countries. Expert Rev Pharmacoecon Outcomes Res. 2013;13:469–82. doi:10.1586/1437167.2013.820956.
41. Olsson E, Kälvemark Sporrong S. Pharmacists’ experiences and attitudes regarding generic drugs and generic substitution: two sides of the coin. Int J Pharm Pract. 2012;20:377–83. doi:10.111/j.2042-7174.2012.00214.x.
42. Olsson E, Ingman P, Ahmed B, Kälvemark Sporrong S. Pharmacist-patient communication in Swedish community pharmacies. Res Social Adm Pharm. 2014;10:149–55. doi:10.1016/j.sapharm.2013.03.001.
43. Wettermark B, Godman B, Jacobsson B, Haaijer-Ruskamp FM. Soft regulations in pharmaceutical policy making: an overview of current approaches and their consequences. Appl Health Econ Health Policy. 2009;7:137–47. doi:10.2165/11314810-000000000-00000.
44. Chronologie: Das Ringen um die Gesundheitsreform. Available at: http://derstandard.at/3404802. Accessed 16 Oct 2014.
45. Hesse U, Godman B, Petzold M, Martin A, Malmström RE. Impact of delisting ARBs, apart from losartan, on ARB utilisation patterns in Denmark: implications for other countries. Appl Health Econ Health Policy. 2013;11:677–85.
46. Gustafsson LL, Wettermark B, Godman B, Andersén-Karlsson E, Bergman U, Hasselström J, Regional Drug Expert Consortium, et al. The ‘wise list’—a comprehensive concept to select, communicate and achieve adherence to recommendations of essential drugs in ambulatory care in Stockholm. Basic Clin Pharamacol Toxicol. 2011;108:224–33. doi:10.1111/j.1742-7843.2011.00682.x.
47. Hakonsen H, Toverud EL. Cultural influences on medicine use among first-generation Pakistani immigrants in Norway. Eurn J Clin Pharmacol. 2012;68:171–8. doi:10.1007/s00228-011-1111-7.
48. Godman B, Petzold M, Bennett K, Bennie M, Bucsics A, Finlayson AE, et al. Can authorities appreciably enhance the prescribing of oral generic risperidone to conserve resources? Findings from across Europe and their implications. BMC Med. 2014;12:98. doi:10.1186/1741-7015-12-98.
49. Kesselheim AS, Stedman MR, Bubrick EJ, Gagne JJ, Misono AS, Lee JL, et al. Seizure outcomes following the use of generic versus brand-name antiepileptic drugs: a systematic review and meta-analysis. Drugs. 2010;70:05–621. doi:10.2165/10898530-000000000-00000.
50. Zuidberg C. The pharmaceutical system of the Netherlands. Vienna, August 2010. https://ppri.goeg.at/Downloads/Publications/The%20pharmaceutical%20system%20of%20the%20Netherlands_FINAL.pdf. Accessed 13 Oct 2014.