E-drug: France to promote sales of generic drugs
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[Some countries need extra time to discover the essential drugs
concept, but eventually they'll get there too. What about working
on improving the quality of prescribing next, France? Copied as fair
use. HH]
BMJ 2001;323:653 (22 September 2001)
News roundup
France to promote sales of generic drugs
Alexander Dorozynski Paris
The results of a survey released by the French social security
administration last week show that only 3.1% of drugs sold in the
country are generic drugs.
The government is now proposing legislation to bring the sales of
generics closer to the average level in other developed countries, in
the hope of saving billions of francs a year.
Sales of drugs account for more than 20% of health costs in
France. The social security administration, which reimburses
patients all or part of the cost of drugs considered to be effective,
is expected to have a deficit of 3.6bn francs (�330m; $480m) this
year.
To alleviate this burden the government will propose, early in
October, legislation aimed at moving France up from the bottom
end of the 22 developed countries in the survey. In the United
Kingdom generics account for more than 20% of drug sales. In
Germany the figure is 40%, and in Poland it is almost 50%. In the
United States, the Netherlands, Canada, and Greece sales of
generic drugs account for more than 10% of drug sales.
According to the social security administration, if about a tenth of
the drugs prescribed by brand name were sold as generics the
savings in health costs would be 2.2bn francs a year.
Most French doctors choose to prescribe brand name
pharmaceuticals. Although pharmacists are allowed to substitute an
equivalent generic product, most do not. Many doctors object to
the substitution, sometimes writing "not to be substituted" on their
prescriptions.
Most patients are not aware that generics are identical to brand
name drugs, resent the "cheap substitute," and apparently shun
pharmacies that have a policy of substitution.
Claude Japhet, president of the main pharmacists' union, the Union
Nationale des Pharmacies de France, blames this on insufficient
information from the government to the public and on the negative
attitudes of some medical unions.
The social security administration points out that information
campaigns can be very effective. For example, health officials in the
Marne region in northeastern France, alarmed by a rapid increase in
health costs five years ago, carried out a vigorous campaign among
health professionals in favour of generics and raised the sale of
generic drugs to 10% of drug sales.
Prescription by the international generic name is a key element of
the legislation, to be proposed by Dr Bernard Kouchner, minister
delegate for health, and employment minister Elisabeth Guigou.
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