Overheid verheugd over Uitkomst

Control of drug costs/expenditures is conceived to be of great importance in the Netherlands. The development of these costs is also dependent on regulations concerning the reimbursement system and pricing. For the Dutch situation, a law on drug prices (WGP) and a drug compensation system (GVS) were developed to control drug expenditures and to stimulate the substitution to cheaper drugs (generics). However, it has recently been suggested that this system is insufficient for these purposes. We investigated costing and substitution developments before and after patent expiry and the introduction of generics for three drugs: enalapril, fluoxetine and ranitidine. Drug use - in terms of prevalence, incidence and DDD's - was rather constant during the period or even slightly increasing. Drug costs decreased relevantly after patent expiry for all three drugs. Furthermore, a relevant substitution (up to 8o%) from patented products (specialties and parallel-imported) to generics was observed. In conclusion, decreasing drug costs for enalapril, fluoxetine and ranitidine, after patent expiry in combination with non-decreasing drug use, does not support the suggestion of insufficient control of drug expenditures with the current system