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Comparison of pharmaceutical policies to stimulate use of generics in Japan and Sweden

Journal article
Authors Shinobu Imai
Karolina Andersson Sundell
K. Fushimi
Published in Health Policy and Technology
Volume 5
Issue 2
Pages 189-195
ISSN 2211-8837
Publication year 2016
Published at Institute of Medicine, Department of Public Health and Community Medicine
Pages 189-195
Language en
Links dx.doi.org/10.1016/j.hlpt.2016.02.0...
Keywords Pharmaceutical policy, Generic substitution, Generic drugs, Japan, Sweden, 4E, health-care, cost-containment, substitution, expenditure, quality, society, europe, impact, Health Care Sciences & Services
Subject categories Public Health, Global Health, Social Medicine and Epidemiology

Abstract

Objectives: Among OECD countries, the proportion of total expenditure on health spent on pharmaceuticals is highest in Japan, 20%. In Sweden, the corresponding proportion is 13%. Swedish pharmaceutical expenditures increased dramatically in the 1990s and policy changes were introduced to curb this. Both countries have introduced policy changes to increase cost containment. This study aims to compare the pharmaceutical policies regarding generic medicines in Japan and Sweden. Methods: Information on pharmaceutical policies was collected. We compared pharmaceutical policies according to the 4E (Education, Engineering, Economics, and Enforcement) component framework developed to describe the differences in policies. Results and conclusions: In Sweden, there were several organizational and managerial interventions within the Engineering class. Japan had several positive incentives for health care actors in the Economics category. The Enforcement category had a stronger legal component in Sweden compared to Japan. The Swedish policies were mainly directed towards prescribing and dispensing whereas the Japanese addressed several stakeholders to promote use of generic drugs. The countries were similar with respect to the Education category. Within the Enforcement component the Swedish policies were legally enforced whereas the Japanese to large extent were recommendations. (C) 2016 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved.

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