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"titulo" => "«Apropos of a case»: do generic drugs help control expenditure on hypertension?"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se analiza desde la perspectiva del pagador (Sistema Nacional de Salud [SNS]) la influencia que tienen los genéricos en el gasto en medicamentos en la hipertensión arterial, examinándose el subgrupo terapéutico de mayor consumo y utilización, los inhibidores de la enzima de conversión de la angiotensina (IECA) y antagonistas de los receptores de la angiotensina II (ARA II).</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Partiendo de los datos de facturación al SNS de todas las oficinas de farmacia del Área de Salud de Málaga, se explora el consumo (envases y gasto) de los fármacos IECA, IECA + especialidades farmacéuticas genéricas (EFG) y ARA II, desde 1999 hasta 2002, así como el precio medio (ponderando según ventas) y el porcentaje de desviación de prescripción de un grupo a otro.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El incremento en envases del subgrupo C09 fue del 20,79%, muy superior para los ARA II (136%) y los IECA + EFG (177%). El gasto total creció en más del 42%. Se redujo el gusto en IECA en casi el 7%, a pesar del incremento en gasto de los IECA + EFG, mientras que los ARA II lo aumentaron en más del 154%. El precio medio ponderado según las ventas de este subgrupo terapéutico se incrementó en cerca del 18%. Se produjo un descenso en el precio medio ponderado de los principios activos donde había EFG (captopril y enalapril) además de otros (trandolapril), pero entre los ARA II destaca el aumento en el precio medio ponderado según las ventas de irbesartán (9%) y valsartán (16%).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los genéricos usados han originado una disminución en el gasto de IECA y del precio medio ponderado del subgrupo. Pero a pesar del incesante aumento en el consumo de las especialidades farmacéuticas genéricas, no se ha producido el efecto ahorrador pretendido con este tipo de medicamentos por el Ministerio de Sanidad y Consumo. Se apunta como posible causa la desviación de las prescripciones hacia los medicamentos no afectados de sustitución por parte de la oficina de farmacia.</p>"
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"resumen" => "<span class="elsevierStyleSectionTitle">Objetive</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In this article we analyze the influence of generic drugs on pharmaceutical expenditure on hypertension from the payer’s perspective (the public health service), by examining the most widely used drugs: angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARBs).</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Based on billing data to the public health service from all the pharmacies in the Health Area of Malaga, we studied the utilization (containers and cost) of ACEi (generic drugs –ACEi+G– and brand name) and ARBs (brand name only) (subgroup C09 – ATC index) from 1999 to 2002. The mean price (weighted according to sales) and the percentage of deviation of prescriptions from one group of drugs to another was also studied.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The increase in consumption of packages in subgroup C09 was 20.79%; the increase was greater for ARBs (136%) and for ACEi+G (177%). The total amount spent during the study period increased by more than 42%. Expenditure on ACEis decreased by almost 7%, despite the increase in expenditure on ACEi+G, whereas expenditure on ARBs increased by more than 154%. The mean price of this subgroup, weighted according to sales, increased by nearly 18%. The mean weighted price of the generic drugs, captopril and enalapril, and that of the brand name, trandolapril, decreased. Notable among ARBs was the increase in mean price weighted according to sales of irbesartan (9%) and valsartan (16%).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The use of generic drugs has reduced expenditure on ACEi and the mean weighted price of the subgroup. However, the increased use of generic drugs has not produced the expected savings for the Department of Health. This could be due to deviation of prescription scores toward drugs not affected by substitution by the pharmacy.</p>"
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