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Article published in THE GLOBAL 1 al 7 February 2010

In the United States there is a real growth slowdown in drug spending in 2003 being the 2007 rate of 1.6%, the lowest since 1974 .

A recent study published in Health Affairs indicates that the causes of this change of trend in the United States are, according to researchers, on three factors. First, the reduction in market entry of new molecules has reduced the weight in the cost of new and more expensive products in the prescription outside the hospital.

Secondly, increased competition between brands and generics, and between active ingredients brand of the same therapeutic subgroup, and this competition has been strongly encouraged by the copayment differentials (the most common: $ 6 for generics, $ 29 for preferred brand drugs and $ 40 for non-preferred brands). As a result, the proportion of generic prescriptions increased from 51% in 2002 to 67% in 2007: no increase in the penetration rate Generic the 2007 expenditure had been a 22% higher.

And thirdly, the case of statins, illustrates the fact that competition from a generic drug (simvastatin) even manages to reduce sales of other brands under patent statins (eg atorvastatin).

Despite the reduction in the rate of increase in spending on medicines prescribed in primary care especially, is notorious for continued strong growth of the drugs prescribed in secondary care ("inflection or shift spending?).
However, this has yet turning a small translation on a market regulated with a small co-payment such as English.
First, in Spain the growth rates of current drug spending for prescriptions dispensed in pharmacies has slowed sharply from the year 2004, although growth has rebounded to 7.2% in 2008 (4 and 5% annually, respectively, when adjusted for population).
Secondly, the entry of generic drugs has led to lower prices for a growing share of extra-hospital use English, and will be even more in coming years as they expiring patents, although the rate of penetration of drugs lower price for the same active substance is lower than in other countries and that, unlike the U.S., sales of active ingredients in the same group under patent are not affected by price competition.
And thirdly, the key differential spending growth-of-hospital first in Spain is the increase in the number of prescriptions continues to be inflexible downwards and that more than offset price reductions when off patent (4 , 6 recipes per person from 2000 to 2008).