Between 2002 and 2006, about 1 billion euros - or $1.6 billion in today's dollars - was “wasted” by the French health care system as a result of docs prescribing brand-name meds rather than generics in just five classes of drugs. Pourquoi? (Why?) The docs were allegedly under pressure from sales,PharmaTimes writes, citing a report by Union Federale des Consummateurs - Que Choisir (UFC-QUE CHOISIR), a consumer group.
The drugs – used in the treatment of gastroesophageal disorders, blood pressure and arthritis, plus anticoagulants and antiplatelet agents for use in prevention of cardiovascular attacks – account for 14% of prescriptions written by French general pracitioners annually, says the consumer group. And the group cites government estimates that in 2002 alone, half of French scrips for the Plavix bloodthinner were “unnecessary or misprescribed,” costing the system $110 million annually. French health service spending on antiplatelet and anticoagulant agents increased 88 percent in this period.
In France, company reps are permitted to visit only docs, who come under greater detailing pressure than anywhere else in Europe, says UFC-QUE CHOISIR. A report from the Ministry of Labour’s General Inspectorate of Social Affairs (IGAS) has estimated that, in 2005, 22,702 sales reps were operating in France, or one for every nine docs. This is twice as many as in the UK and Germany and four times as many as in the Netherlands, says IGAS, which estimates that this level of detailing costs the industry the equivalent of nearly $40,000 per doc.
Moreover, France provides the lowest levels in Europe of pharmacology training for its med students, while under new public health legislation, 90 percent of medical training and continuing ed is now funded by the industry, says the consumer group. To rectify the situation, the group is calling on the Health Ministry to create a force of 1,700 public medical visitors, under the control of the National Authority for Health, to offer "objective" info. This would cost about $315 million annually, and could be funded by taxes on pharma marketing activities, says UFC-QUE CHOISIR.
Until this can be achieved, the government should raise taxes on drug promotion and take steps to reduce rep visits that relate to the most “problematic” drugs, the group proposes.
Historically, France’s use of generics has been very low. In 2001, the social security administration reported that they accounted for just 3.1 percent of all drug sales. Since then, government measures to encourage generics have had some success, and in 2007 their retail sales reached $3.7 billion, or 8.6 percent of the total market by value and around 18 percent by volume.