The Spanish government has been told that its recent introduction of “overly-harsh” pharmaceutical price-cutting measures needs to be balanced with initiatives to encourage the prescribing and dispensing of generic drugs.

Generics currently hold very low market shares in Spain - just 14% in terms of volume and 6.5% by value - and the government is seeking to double these levels over the next three years, although the local generic industry group, the AESEG, says penetration needs to reach at least 50% during this period.

To achieve this goal, the regional public health authorities must be encouraged to offer doctors financial incentives to prescribe generics, says the European Generic Medicines Association (EGA), in a letter to Spain’s Minister for Health and Social Policy, Trinidad Jimenez. Physicians need to be allocated prescription budgets and granted the discretion to use any savings made to prescribe more expensive treatments where necessary, and steps should be taken to raise their awareness of the benefits of generics, its adds.

Moreover, the EGA has told the minister that pharmacists should receive guaranteed rewards for dispensing generics, especially as it is currently not economically advantageous for them to do so in some markets because of low prices, while public information campaigns are needed to assure consumers of the quality and affordability of generic medicines.

Since generics were first introduced in Spain 10 years ago, 5,105 such products have been approved and their use has saved the national health system 10.5 billion euros, according to AESEG director general Angel Luis Rodriguez de la Cuerda, writing recently in the Journal of Generic Medicine. Those savings could double over the next 10 years if generics’ market share could reach the levels seen in most northern European countries, he adds.

He also points out that, according to surveys, 85% of patients say they will accept a generic medicine, but they feel comfortable when it is either prescribed by a doctor or recommended by a pharmacist. “There is still a lot of work to be done with patients in terms of enhancing awareness about generics and their advantages,” he says.

Last September, AESEG made a number of proposals to the government aimed at boosting Spain’s low levels of generic use, including automatic pricing and reimbursement status for the products and an overhaul of the reference pricing system. Both generic industry and pharmacy groups point out that, due to the low prices of off-patent originator products in Spain, there is little incentive for generic drugmakers to introduce their products there.

The EGA’s letter to the minister stresses the importance of putting in place “coherent” policies that incentivise patients, physicians and pharmacists to use generic medicines in order to ensure the affordability and sustainability of health care. “It is in the interests of all European patients and health care systems that prescription decisions should take account of the affordability and cost-effectiveness of different medicines,” it says.