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Reducing the costs of medicine by dispensing generic medicine 25 September 2013 PowerPoint Presentation
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Reducing the costs of medicine by dispensing generic medicine 25 September 2013. Presented by: Christo Rademan – Managing Director. Where does the data come from? Legislation regarding generic substitution Generic utilisation trends in Namibia

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slide1

Reducing the costs of medicine by dispensing generic medicine

25 September 2013

Presented by:

Christo Rademan – Managing Director

contents
Where does the data come from?

Legislation regarding generic substitution

Generic utilisation trends in Namibia

Factors that drive generic utilisation

Measures to promote generic utilisation

Contents
mediscor pbm
Mediscor PBM
  • Pharmaceutical Benefit Management Company
  • Experienced – was established in 1989 and has been in business for more than 24 years
  • An independent company with 119 staff members
  • 85 Clients: medical schemes, insurance products, sick funds, price files
  • More than 1.6 million lives
  • Namibia: 4 open & closed schemes
slide4

Legislation: Mandatory generic substitution

  • Medicines and Related substances control Act, 2003 (Act 13 of 2003)
  • Came into effect August 2008
  • “A pharmacist must inform all members of the public of the benefits of substituting the requested medicine with an interchangeable multi-source medicine”
  • “And may dispense an interchangeable multi-source medicine instead of the medicine on the prescription”
slide5

Generic utilisation rate (2013)

  • Namibia 31-45%
  • RSA 53%
  • USA 70%+
slide7

Generic utilisation trends

South Africa

73.2%

57.0%

53.4%

43.0%

26.8%

27.7%

19.8%

15.3%

slide9

Generic utilisation trends

Namibia

61.9%

61.1%

Legislation had no impact

47.5%

44.9%

slide10

Generic utilisation trends

Namibia

61.9%

61.1%

47.5%

44.9%

38.1%

38.9%

16.2%

14.7%

slide11

Generic utilisation 2013

% Expenditure

% Volume

slide12

Generic utilisation

Per benefit category (2013)

slide13

Generic medicines as a source of affordable health care

Originals - valid patent

Originals - expired patent

Generic equivalents

Based on 2013 data

slide14

Cost per item – SA vs. Namibia

R2.52

N$1.72

N$1.51

R1.39

N$1.00

R1.00

slide15

Current dispensing fee structure – SA vs. Namibia

NB: Namibian fee structure rewards dispensing expensive products

slide16

SA maximum legislated dispensing fee

Government Gazette, 19 November 2010

slide18

Factors that drive / influence generic utilisation

  • Availability of generic alternatives
  • Mandatory generic substitution
  • Prescriber and provider education / attitudes
  • Provider incentives
  • Procurement behaviour of providers
  • Consumer education
  • Funder rules / benefit design
    • Generic reference pricing
    • Formularies
slide21

Promoting generic utilisation - funders

Active pharmacy management

Engaging roll players to promote generic utilisation

Provider engagement – actively monitor pharmacy performance

  • Applying management tools (Patient Experience Monitor)
  • Monitoring co-payments at the point of service
  • Engaging with pharmacy to change dispensing behaviour
  • Specifying acceptable, cost-effective products during chronic authorisation
slide22

Promoting generic utilisation - funders

Member engagement – inform member of cost-effective generic alternatives

  • Promote high-performing pharmacies by area
  • Communicating these pharmacies via the authorization process
  • SMS messaging to members regarding co-payments
  • Communicating quarterly with pharmacies
slide24

Mediscor Pharmacy Management

Objectives:

  • To actively work with Pharmacy to optimize dispensing behaviour
  • To reduce member co-payments, driving the concept of a ‘wallet-free’ experience
  • To drive generic substitution towards the use of Mediscor reference price (MRP) products
  • To drive members towards network pharmacies

Ensures cost-effective delivery of benefits

slide25

Value of PEM – Optimizes the experience

  • Measures the ideal behaviour per line
    • That can be rolled up by Option, Pharmacy, Group, etc.
    • Very powerful
  • Enables meaningful engagement at Pharmacy level
  • Enables network contracting and management

Provides the ability to form preferred partnerships

slide28

Conclusion

  • Generic utilisation decreased over the past 4 years
  • 16% of volume is from brands with patent expired
  • Multiple factors influence generic utilisation
  • Legislation had no impact!
  • Behaviour change needs to be driven by:
    • Rewards & incentives
    • Education
    • Provider engagement
  • Misalignment of provider and funder interests to be resolved
slide29

Thank you!

Any Questions?