In reply: The main purpose of our recent article1 was to quantify estimates of pharmaceutical expenditure over the next decade using various assumptions regarding the price and use of generic statins. We report estimates of billions of dollars in potential savings associated with various scenarios that increase the current off-patent statin use in Australia from around 25% of prescriptions to between 50% and 100%. Simoens misinterprets our conclusions as recommending only using generic statins in Australia. We do not advocate any particular level of generic substitution, but argue that the optimal mix of patented and generic statins should be determined by using cost-effectiveness analysis.
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- 1. Clarke PM, Fitzgerald EM. Expiry of patent protection on statins: effects on pharmaceutical expenditure in Australia. Med J Aust 2010; 192: 633-636. <MJA full text>
- 2. Kanavos P, Seeley L, Vandoros S. Tender systems for outpatient pharmaceuticals in the European Union: evidence from the Netherlands, Germany and Belgium. London: LSE Health, 2009.
- 3. Ontario Ministry of Health and Long-Term Care. Update R1 Ontario Drug Benefit Formulary/Comparative Drug Index No. 41. Effective June 18, 2010. Summary of changes. http://www.health. gov.on.ca/english/providers/program/drugs/formulary/41_update_r1_20100608.pdf (accessed Sep 2010).
- 4. Memorandum of Understanding between the Australian Government and Medicines Australia. http://www.health.gov.au/internet/main/publishing.nsf/Content/C6EC4D1258BBFFB6CA257721000520A2/$File/MOU%20MA.pdf (accessed Sep 2010).
Philip Clarke has received funding from Servier Laboratories Australia for travel to attend the International Society for Pharmacoeconomics and Outcomes Research 2010 Conference to present work related to the ADVANCE study.