Currently, many governments have introduced austerity reforms to control pharmaceutical expenditure. In Austria, efforts have been made to both increase the use and lower the prices of generics. The problem is that antidepressants are not like other drugs, such as cholesterol-reducing medicines, where switching from originators to generics is not seen as a problem. For antidepressants the patient’s treatment is often tailored to meet their specific needs and there is resistance to switch products in stable patients.
Godman et al. carried out a study into whether Austrian reforms had affected the use of antidepressants by investigating use of risperidone versus other atypical antipsychotic medicines over time following generic availability. No analysis of expenditure was undertaken as generic risperidone was already available by 2005 (when the study started) and reduced expenditure for risperidone is guaranteed given the current strict regulations governing the prices of generics and originators in Austria once generics become available.
Risperidone is a dopamine antagonist belonging to the class of atypical antipsychotics. It is used to treat schizophrenia, schizo-affective disorder, bipolar disorder and irritability in people with autism. The drug lost its patent and data exclusivity protection in Austria in 2003–04.
The retrospective observational study covered the period from 2005, i.e. one year after generic risperidone became available; to 2010, six years after generic risperidone became available. There was increased use of risperidone after generic risperidone became available. However, the 81% growth in overall atypical antipsychotic use from 2005 to 2010 [defined daily dose (DDD) basis] was principally driven by increased use of the newer antipsychotics quetiapine and aripiprazole. This resulted in the use of risperidone as a percentage of total atypical antipsychotic DDDs decreasing from 32% in 2005 to 24% in 2010.
The authors concluded that ‘specific measures are needed to encourage the prescribing of generic risperidone when multiple choices are appropriate’. Measures may include prescribing restrictions for newer antipsychotics, such as duloxetine for which no generics yet exists. No specific measures are currently being planned for generic atypical antipsychotic drugs in Austria.
Editor’s comment
Readers interested to learn more about the instruments applied to improve uptake of generics in Austria are invited to visit www.gabi-journal.net to view the following peer reviewed article due to be published in GaBI Journal:
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