“Evergreening” and other stories . . .

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f3869 (Published 25 June 2013) Cite this as: BMJ 2013;346:f3869

“Evergreening” is the name given to the strategies used by pharmaceutical companies to keep their market share for a product after the 20 year period of exclusive manufacturing rights has expired. A typical strategy is to create slightly modified follow-on drugs, typically entaniomers such as escitalopram and esomeprazole in place of generic citalopram and omeprazole. And there are a number of other ways to persuade prescribers to stick with named brands or to avoid generics. Most health systems try to combat this with the use of restricted formularies, and Geneva in Switzerland is no exception. But a cost evaluation analysis in PLOS Medicine (2013, doi:10.1371/journal.pmed.1001460) finds that these strategies achieve limited success. The researchers calculate that had all brand and follow-on drugs been replaced with generics, Geneva alone could have saved €30.3m (£25.7m; $40.3m) over an eight year period.

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