An investigation into generic medicines and generic substitution in the medical field

Van der Merwe, P. J. (Pieter Jacobus) (2000-12)

Thesis (MBA)--Stellenbosch University, 2000.

Thesis

ENGLISH ABSTRACT: This study is essentially an investigation into perceptions that exist in the medical field with regards to generic medicines and generic substitution. The study was conducted via the sampling of a variety of physicians, specialists and pharmacists in the Cape Peninsula. The primary test for these perceptions was the application of a five page questionnaire that the targeted sample group had to complete. South Africa entered a new era on political, social and economic levels with the election of a new democratic government. The reality is that South Africa is becoming more and more a third world country with deteriorating systems of health care and education, as a direct result of a shortage of funds and inadequate management or total lack thereof. It has also become more and more evident recently that this country is experiencing a "brain-drain", in that experienced and highly qualified people are leaving the country for mostly other first world countries, because they can no longer operate efficiently and effectively under the constraints imposed upon them by a shrinking health care budget. Government and private health departments constantly have to face the battle of containing costs so that they can operate in the way that they are supposed to. Unfortunately, with the constant escalation in the prices of medicine every year combined with a limited availability of funds, the problem just becomes worse every day with patients and medical aids suffering the most. One possible way in which an attempt could be made to reduce costs is to decrease the expenses of medicine, making more money available in other areas, or that the need for more medicines could be satisfied via having more money available as a result of these savings. Generic medicines are known to be less expensive than their ethical counterparts and can therefore contribute greatly to savings in this area, seeing that generic medicines mostly sell at 40%-50% of the price of the original. There are obviously more issues involved than just costs: the ethical issue of moral support to the ethical manufacturers that have done all the research and development of the original drug that now becomes "copied"; the issue of.quality and reliability of these "copycat" medicines; and the issue of the role that people in the medical field, government and other bodies should play in containing costs. These issues were addressed in the form of statements in the questionnaire and opinions were tested to see what perceptions exist, so that the marketers of medicines would know how to formulate their marketing plans and strategies in order to attain a bigger market share, or how to protect their current share of the market. The information should also prove handy to government and private health care organisations that should endeavour to contain costs wherever they can, seeing that they operate within the constraint of an allocated budget.

AFRIKAANSE OPSOMMING: Hierdie studie projek is essensieel 'n ondersoek na persepsies wat bestaan in die mediese veld met betrekking tot generiese medisynes en generiese plaasvervanging. Vir die doel van die studie is "mediese veld" gedefinieer as die verskillende kategorieë van mediese dokters en aptekers wat elke dag met die vraagstuk te make het. Die steekproef was dus mediese dokters, spesialiste en aptekers in die Kaapse Skiereiland. Die primere toetsinstrument was 'n vyf-bladsy vraelys wat 35 stellings bevat het waarin 8 faktore verskans was waarvoor die navorser getoets het. Suid-Afrika het 'n nuwe era betree met die daarstelling en verkiesing van 'n nuwe demokratiese regering van nasionale eenheid waarin alle Suid-Afrikaners deelname het. Die realiteite van Suid-Afrika vandag is dat dit meer en meer sy derde wêreld komponente openbaar waarvan die bestaan vantevore deur die eerste wêreld komponent geïgnoreer is. Die resultaat is dat gesondheidsorg en opvoedkundige sisteme aan die verkrummel is vanweë 'n tekort aan fondse asook oneffektiewe bestuur. Dit is dan ook onvermydelik dat 'n groot aantalleiers en kenners op hierdie gebiede besluit om die land te verlaat en na hoofsaaklik eerste wêreld lande emigreer, waar hulle in 'n veel mindere mate te kampe het met die probleme van swak bestuur en veral onder befondsing in die onderskeie areas van hulle spesialiteit. Dit laat 'n gaping wat gevul moet word deur swakker bestuur wat die probleem vererger. Regering- en privaat mediese departemente gaan gebuk onder die las van krimpende begrotings en 'n stygende vraag na mediese sorg, medisynes en ander geriewe. Dit is ook 'n voldonge feit dat mediese tariewe bly styg, dat medisynes konstant al hoe duurder word en dat daagliks waargeneem word dat daar 'n ondervoorsiening van personeel en medikasie in hospitale en ander gesondheidsorganisasies is. Die partye wat aan die kortste end trek is die pasient en die mediese fondse. Een moontlike wyse waarop hierdie probleem van stygende kostes aangespreek kan word is om die uitgawes op medisynes te beperk sonder om minder medisynes te koop, sodat meer geld beskikbaar sal wees vir ander behoeftes. Dit is bekend dat generiese medisynes heelwat goedkoper is as hulle etiese "broers" en dat die gebruikmaking hiervan kan lei tot besparings so groot as selfs 60% en meer. Daar is duidelik meer vraagstukke betrokke rondom die hele aangeleentheid van generiese medisynes en generiese plaasvervanging soos: die etiese vraagstuk aangaande morele ondersteuning aan die etiese firmas wat al die navorsing en ontwikkeling van die oorspronklike produkte doen en wat nou net gedupliseer word deur die generiese vervaardigers; die vraagstuk aangaande die betroubaarheid en kwaliteit van hierdie "duplikate"; asook die vraagstuk rondom die rol wat persone in die mediese veld en regerings- en- privaatinstansies moet vervul in die bekamping van stygende kostes. Hierdie vraagstukke is geadresseer in die vraelyste as stellings en opinies is getoets om vas te stel wat die huidige persepsies rondom die aangeleentheid van generiese produkte en generiese plaasvervanging is. Die belang van die kennis van hierdie opinies en persepsies is dat dit onontbeerlike inligting verskaf aan die bemarkers van farmaseutiese produkte en medisynes aangesien 'n bemarkingsplan en bemarkingstrategie hier rondom gevorm kan word, sodat maniere uitgewerk kan word om markaandeel te vergroot of om markaandeel te behou.

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