PT  - JOURNAL ARTICLE
AU  - Cristián Mansilla
AU  - Jorge Cárdenas
AU  - Warren A. Kaplan
AU  - Veronika J. Wirtz
AU  - Lucy Kuhn-Barrientos
AU  - Matías Ortíz de Zárate
AU  - Tatiana Tobar
AU  - Cristian A. Herrera
TI  - Evaluation of the effects of a generic substitution policy implemented in Chile
AID  - 10.1136/bmjgh-2018-000922
DP  - 2019 Mar 01
TA  - BMJ Global Health
PG  - e000922
VI  - 2
IP  - Suppl 3
4099  - http://gh.bmj.com/content/2/Suppl_3/e000922.short
4100  - http://gh.bmj.com/content/2/Suppl_3/e000922.full
SO  - BMJ Global Health2019 Mar 01; 2
AB  - Introduction Chile implemented a generic substitution policy in 2014 to improve access to medicines. This study aims to measure if the generic substitution policy had an effect on the sales volume and prices of referent and the branded generic products with demonstrated bioequivalence (BEQ) in the private pharmaceutical market.Methods The volume and total private sales of medicines sold at private sector retail outlets between November 2011 and October 2016 were considered in the analysis. We calculated the total number of daily defined doses (DDD) by adding up the number of DDDs of different presentations with the active pharmaceutical ingredient (API). We determined the ratio of the median prices of all BEQ per DDD presentations compared with the median price of the corresponding referent presentations per DDD in 2011 and 2016. Sixteen APIs representing 231 different conventional-release presentations were included in the analysis.Results Overall, the volume of sales of the referent products decreased over time after the intervention. However, this reduction was not mirrored by an increase in the corresponding branded generic BEQ volumes overall. In all cases, the median price per DDD of the referent was higher than its BEQ counterpart in 2011 and 2016.Conclusion Since referent products are more costly than branded BEQ generic products, reducing their consumption—and increasing the BEQ availability—should improve access to medicines in Chile. However, this must be accompanied by promotion of BEQ products to ensure savings for consumers in the long term. Future research should focus on identifying facilitating and inhibiting factors of generic substitution.