Unvealing the determinants of drug switching after patent expiration

Speaker:  Matteo Lippi Bruni - University of Bologna
  Thursday, January 16, 2025 at 12:00 PM

In this paper, we investigate the determinants affecting the transition from branded to generic drugs following patent expiration. This process arises from a complex interplay among patients, prescribers, and pharmacists. Our analysis draws on the dispensation of a large sale lipid-lowering drug (atorvastatin) within the Italian National Health Service (NHS), which experienced generic entry in March 2012. Exploiting individual-level data, we construct consumption trajectories of patient purchasing behaviour around the patent expiration date. We encompass both short- and medium-term horizons, considering separately initial purchase decisions and patterns observed over one-year period. Our analysis highlights the key role of patient characteristics in driving inertia in retaining the off-patent version of the drug. Specifically. we show that indicators of more severe health conditions are strongly associated with delays in generic adoption. Although the impact of general practitioner (GP) and practice attributes on immediate switching behavior is relatively limited, these factors exhibit a more pronounced influence over the medium term. Furthermore, we identify the critical role of financial incentives in facilitating the transition to generic alternatives, while GP’s inherent propensity for branded drug hinders patients’ adoption of generics. Finally, we assess the robustness of our findings by accounting for choice of the pharmacy that dispenses the drug.


Programme Director
Paolo Pertile

External reference
Publication date
November 11, 2024

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