France to promote sales of generic drugsBMJ 2001; 323 doi: http://dx.doi.org/10.1136/bmj.323.7314.653/a (Published 22 September 2001) Cite this as: BMJ 2001;323:653
The results of a survey released by the French social security administration last week show that only 3.1% of drugs sold in the country are generic drugs.
The government is now proposing legislation to bring the sales of generics closer to the average level in other developed countries, in the hope of saving billions of francs a year.
Sales of drugs account for more than 20% of health costs in France. The social security administration, which reimburses patients all or part of the cost of drugs considered to be effective, is expected to have a deficit of 3.6bn francs (£330m; $480m) this year.
To alleviate this burden the government will propose, early in October, legislation aimed at moving France up from the bottom end of the 22 developed countries in the survey. In the United Kingdom generics account for more than 20% of drug sales. In Germany the figure is 40%, and in Poland it is almost 50%. In the United States, the Netherlands, Canada, and Greece sales of generic drugs account for more than 10% of drug sales.
According to the social security administration, if about a tenth of the drugs prescribed by brand name were sold as generics the savings in health costs would be 2.2bn francs a year.
Most French doctors choose to prescribe brand name pharmaceuticals. Although pharmacists are allowed to substitute an equivalent generic product, most do not. Many doctors object to the substitution, sometimes writing “not to be substituted” on their prescriptions.
Most patients are not aware that generics are identical to brand name drugs, resent the “cheap substitute,” and apparently shun pharmacies that have a policy of substitution.
Claude Japhet, president of the main pharmacists' union, the Union Nationale des Pharmacies de France, blames this on insufficient information from the government to the public and on the negative attitudes of some medical unions.
The social security administration points out that information campaigns can be very effective. For example, health officials in the Marne region in northeastern France, alarmed by a rapid increase in health costs five years ago, carried out a vigorous campaign among health professionals in favour of generics and raised the sale of generic drugs to 10% of drug sales.
Prescription by the international generic name is a key element of the legislation, to be proposed by Dr Bernard Kouchner, minister delegate for health, and employment minister Elisabeth Guigou.