Review article
Reference Pricing System and Competition: Case Study from Portugal
Conceiçăo Portela
; Health Sciences Department, Lusofona University of Humanities and Technology, Lisboa, Portugal
Abstract
Aim To characterize the patterns of competition for a sample
of drugs in the Portuguese pharmaceutical market before
(January 2002-March 2003) and after (April 2003-June
2003) the introduction of the reference pricing system
(RPS).
Methods We performed a descriptive, retrospective, longitudinal
analysis, with monthly observations from January
2002 until June 2003 of 15 homogeneous groups. The
groups represented the upper limit of public pharmaceutical
expenditure in the RPS segment in 2003 (n = 270). Measures
of competition were: 1) number of presentations; 2)
prescriptions’ concentration in the generic and originator
(brand) segments, using Herfindahl-Hirschman Index
(HHI); and 3) dominant positions of market leader in the
homogeneous group. A correlation analysis between the
number of presentations, the HHI, and the dominant position
of the market leader was performed using Pearson
coefficient of correlation.
Results The structure of the market changed with the introduction
of RPS. We found an increasing number of generic
presentations (from 4 ± 3 to 7 ± 4; mean ± standard
deviation) and a decrease in the HHI for the generics market
segment (from 0.7 ± 0.2 to 0.6 ± 0.3). There was a negative
correlation between those variables that increased after
the introduction of RPS (from -0.6 to -0.8). The HHI for
brands and the dominant positions remained unchanged.
Conclusion After the implementation of RPS, the increased
competition was mainly driven by economic and
social agents in the generics market segment but not in
the brands market segment.
Keywords
Reference pricing system; competition; pharmaceutical expenditure; generics; reimbursement
Hrčak ID:
47863
URI
Publication date:
15.10.2009.
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