A combination of weak national guidelines and powerful marketing by the pharmaceutical industry has led to a rise in brand-name over generics prescriptions for psychopharmaceuticals in Croatia.
Marina Polić-Vižintin of the Dr Andrija Štampar Institute of Public Health in Zagreb and colleagues looked at data on the number of drug packages and buying price for all prescription drugs registered in the Republic of Croatia from all pharmacies in Zagreb between 2001 and 2010 .
The authors found that, despite an increase in the number of generics included in the Croatian Institute of Health Insurance (CIHI) drug list, generic psychopharmaceuticals had slipped in uptake, making up a smaller share of the total drug use over that time. Drug use was measured by both defined daily doses (DDD)/1,000/day and by financial indicators.
The total cost of psychopharmaceuticals over the 10-year period increased by 20.1%, more for brand-name than for generic agents (32.7% vs 7.4%). The highest share of generic psychopharmaceuticals as compared with brand-name drugs according to DDD/1,000/day was in psycholeptics (83.6% in 2001 vs 82.2% in 2010), most in hypnotics and sedatives, and least in antipsychotics.
The share of generic psychopharmaceuticals in total drug use according to financial indicators decreased by 9.6% and according to DDD/1,000/day by 12%.
Many European countries have stimulated generics prescriptions in order to rationalize drug consumption and costs [2, 3]. This, coupled with reference pricing, has prompted a relative rise in generics prescriptions. Croatia, however, has not effectively encouraged generics prescribing.
Although mental disorders are complex diseases and physicians are reluctant to switch therapy, there is room for additional savings to be made by stimulating the use of generics, conclude the authors. Specific measures – including national guidelines and education on the quality, safety and efficacy of generics – are needed to stimulate prescribing generic antidepressants and antipsychotics, they write.
Conflict of interest
The authors of the research paper  declared that there were no conflicts of interest.
1. Polić-ViŽintin M, Stimac D, Sostar Z, Tripković I. Distribution and trends in outpatient utilization of generic versus brand name psychopharmaceuticals during a ten-year period in Croatia. BMC Health Serv Res. 2014;14:343.
2. GaBI Online – Generics and Biosimilars Initiative. Changes to pharmaceutical policy during an economic recession [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2014 Nov 28]. Available from: www.gabionline.net/Generics/Research/Changes-to-pharmaceutical-policy-during-an-economic-recession
3. GaBI Online – Generics and Biosimilars Initiative. Country Focus Poland Market Analysis [www.gabionline.net]. Mol, Belgium: Pro Pharma Communications International; [cited 2014 Nov 28]. Available from:www.gabionline.net/Country-Focus/Poland/Market-Analysis