Generic drugs accounted for over 60% of all US prescriptions filled last year, at 2.4 billion prescriptions compared with 1.4 billion for brand-name drugs, and by the end of this year will account for two-thirds of all prescriptions, says new research.

US prescriptions for generics and branded drugs reached equilibrium in 2005 but generics have continued to build momentum each year thereafter, increasing at a compound annual growth rate (CAGR) of 12% since 2004. Conversely, branded drugs slowed pace to a negative 6% CAGR for the same period, and last year saw an unprecedented spread of one billion prescriptions between the two, according to business intelligence specialist Wolters Kluwer Health’s latest Pharma Solutions report._

“These trends are going to become even more pronounced moving forward, as there are many blockbusters in major therapeutic areas like cholesterol reducers due to come off-patent in the coming three years,” forecast Mark Spiers, chief executive at Pharma Solutions. “The volume of available generics will increase, and there are very few new blockbuster drugs in the pipeline to replace them,” he added.

The study also found that “prescription abandonment” by consumers - when a patient submits a retail prescription to a pharmacy but never actually picks it up - increased from an average of 5.15% in 2006 to 6.8% in 2008, a jump of 34%. Moreover, abandonment increased as the amount of the patient’s co-payment increased, especially for new prescriptions. For example, new prescriptions with co-pays of $100 or more carried an abandonment rate of just over 20% last year, while for those with co-pays of $10 or under, the abandonment rate was only 4%.
_
“Price sensitivity is clearly a factor as consumers decide to forego certain prescriptions altogether, including some for chronic conditions,” commented Mr Spiers, and he warned: “this disturbing trend may have serious health implications and seems poised to continue, especially if the economy deteriorates further.”

Many factors have contributed to the steady growth of generic prescriptions, among the most prevalent being education, awareness and changing attitudes among patients. They are becoming far more comfortable with the concept of using a generic in place of a brand, which is due not only to patient education programmes but also “enthusiasm forged by marketing vehicles such as $4 generic drug programmes,” said Mr Spiers.
_
The economy is also playing an enormous role in patient decision-making, the study shows. As third-party insurers set higher patient co-payments for branded medicines, patients are reacting by choosing generic alternatives. The economic downturn will further drive both this demand and prescription abandonment, it forecasts. “Increased unemployment and high numbers of newly uninsured are encouraging patients to look for ways to cut costs. Choosing a generic over a brand fits right into that mindset,”_ concluded Mr Spiers.