Generic substitution is the term applied to the substitution of a prescribed branded drug by a different form of the same active substance.The generic is usually unbranded; it is often a parallel imported product, which is regarded as 'essentially similar' by the EU Commission. Generic substitution becomes possible when the patent life of the active substance has expired. In the UK, generic substitution was raised as a means of reducing the NHS medicines bill in the Greenfield Report of 1983 [1].The proposal was not implemented, but an initiative to encourage generic prescribing resulted in a change in doctors' prescribing habits towards the greater use of generics. Within a decade, the overall shape of the NHS market had changed dramatically, so that by 1993 generic products accounted for 11% of the NHS expenditure on drugs and 41% of the volume. Prescriptions for branded products within their patent life accounted for 26% by value but only 7% by volume.The bulk of the NHS prescription market, 63% by value and 52% by volume, comprised active substances that were out of patent but still prescribed by brand name. Clearly, there was room for further savings by encouraging greater prescribing of generics, and it was considered likely that government negotiations in 2009 on the long-established Pharmaceutical Price Regulation Scheme (PPRS) [2] would result in mandatory generic substitution, but this was not adopted.
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