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They have the same active ingredient, the same pharmaceutical form, the same dosage, the same route of administration and the same therapeutic indications. Only the name changes (which is that of the active ingredient) and the box that contains them which is perhaps different in shape and colour. We are talking about equivalent medicines – also called generic in a “pejorative” way – which have the same effectiveness as “brand” originator medicines. It’s a shame, however, that they haven’t yet made their way into the hearts of Italians, so much so that one citizen in 3 doesn’t trust and still has doubts about the fact that they have the same properties and for this reason spends more to have the branded one that has become commonly used for his fictitious name (the most famous case is perhaps that of tachipirina).
For Italians an additional expense of over 1 billion
The main consequence of this purchasing choice, namely that of not accepting the equivalent drug when the pharmacist offers it – which, it is worth underlining, has the same active ingredient and efficacy as the original branded medicine – is that the private expenditure of Italians to purchase branded medicines is growing while the use of the equivalent alternative is still low, especially in the South. It should in fact be remembered that if the citizen asks for the “branded” medicine instead of the “generic” one he will have to pay the difference between the price of the medicine requested and the reimbursement price of the equivalent. It’s about a extra expense entirely borne by patients’ pockets, worth 1.1 billion in a year: basically a “waste” that could be saved if the equivalent were chosen, without forgetting that their arrival on the market determines discounts and lower prices for branded ones (estimated at around 6 billion). The picture of the equivalents market was drawn on the occasion of the conference at the Ministry of Health “Equivalent drugs: knowing to choose”, promoted by Cittadinanzattiva as part of the “Ioequivalgo” campaign with the unconditional contribution of Egualia.
The most requested equivalent in the North, much less in the South
From a survey just carried out by SWG on a sample of 2500 citizens, it also emerges that 1 citizen in 5 declares that the doctor only indicates brand drugs on the prescription, but at the same time 47% of Italians would be willing to purchase the equivalent, while 19% persist who would still prefer the brand. Thus private spending, i.e. ‘out of pocket’, of citizens is growing: in 2023 Italians paid 1,029 million euros in price differential out of their own pockets to buy the most expensive brand drug instead of the lower cost generic equivalent fully reimbursed by the NHS. However, the use of equivalent treatments continues to be favored in the North (represents 39.8% of packs sold) compared to the Center (29%) and the South (23.7%), compared to an Italian average of 32%. The highest incidence of consumption is in the PA of Trento (44.7%), in Friuli Venezia Giulia (41.9%), in Piedmont (40%). In the queue for consumption of equivalents are Sicily (22.7%), Campania (21.9%), Calabria (21.7%).
Private spending on medicines by citizens is growing
From research by Sant’Anna High School of Pisa it also emerges that in 2022 the expenditure borne by citizens, including the share of co-payment (regional and differential tickets), the private purchase of class A medicines and the expenditure of class C medicines, amounted to 9.9 billion , with an increase of 7.6% compared to 2021. All with one constant: spending on co-participation is generally higher in low-income regions. «With the traveling villages of the Ioequivalgo countryside we stopped in 22 cities and signed memoranda of understanding with some Regions. We believe that at this point a major institutional information and communication campaign aimed at citizens and healthcare workers is necessary to overcome cultural resistance but also practical obstacles in the demand and supply of these drugs”, he declared Valeria Fava of Cittadinanzattiva.
A communication companion and indications to pharmacists
On the equivalent drugs front, the Undersecretary of Health Marcello Gemmato stated that the ministry «will evaluate the launch of a communication campaign on equivalent drugs: it must be reiterated that they have the same effectiveness as their originators, therefore there is no reason not to use them, in addition to resulting in significant savings both for the State and for citizens.” Gemmato also recalled that pharmacists have the legal obligation to offer citizens the equivalent medicine when possible. In this regard, the president of Federfarma, Marco Cossoloannounced a new circular to pharmacists to remind them of the obligation to offer equivalents but also to underline the importance of correct communication to citizens regarding the effectiveness and characteristics of these medicines.
