Strategies to improve the acceptance and use of generics .

1. Strategies to improve the acceptance and use of generics. Jordan Pharmaceutical Association Dr.Taher Shakhashir

2. Introduction to Pharmaceutical Association. • HAI data analysis. • Situation of pharmaceuticals in Jordan • Generic Strategy proposal.

3. 1957 - 2007

4. Jordan Pharmaceutical Association • Established in 1957 celebrating our 50th anniversary. • Profession is highly regulated and governed by the “Law of Pharmacy & Drugs” of 2001. • The JPA is run by an elected board. • Membership in JPA: around 10100 registered pharmacists and most of them are active practicing pharmacists.

5. Jordan Pharmaceutical Association • Number of pharmacies: 1958 employing 3500. • Number of drugstores: 317 employing 4500 • Number of manufacturing plants: 16 employing 8000

6. Jordan Pharmaceutical Association • 1950 - 1990 : 2559 Pharmacists • 1991 – 2001 : 5022 Pharmacists • 2002 – Now : 3102 Pharmacists

7. Jordan Pharmaceutical Association • Males represent: 53% • Females represent: 47%

8. HAI data • According to HAI data(2003), approximately 70% of the population is covered by health insurance, provided by: • Ministry of Health (21%)Royal Medical Services (33%),Refugee missions (18%), Private insurance (10%). • ===========Total of 82 % insured….. Not 70% !!!!!i

9. HAI data analysis • The study was performed in 2003/2004, before implementing the new pricing guidelines. (JFDA Pricing regulations are used as a reference in neighbouring countries). • Total Market consumption is directly affected by the following conditions in the area: • Jordan is one of the main destinations for MENA for Medical Tourism. • Iraqi crisis: number of Iraqis in Jordan, and medicine export to Iraq. • Palestinian crisis: Mobile hospitals, medicine donations. • International UN forces, and the accompanied Jordanian Hospitals.

10. HAI data analysis • 2004: • Total pharmaceutical market: JD 140 millions - Imported: JD 105 millions (export price) - Local manufacturing: JD 35 millions (25% of total market) • GDP: JD 8.1 Billions • Pharmaceutical consumption is: 1.87% of GDP. 18.4% of total health expenditure. • These figures include Export to Iraq, Palestine, UN international forces and Health tourism. • Refs: J-FDA statistical data, HAI data.

11. HAI data analysis • 2006: • Total pharmaceutical market: JD 220 millions: - Imported: JD 165 millions (export price) - Local manufacturing: JD 55 millions (25% of total market) • GDP: JD 10.3 Billions • Pharmaceutical consumption is: 2.13% of GDP. 22.7% of total health expenditure. • These figures include Export to Iraq, Palestine, UN international forces and Health tourism. • Refs: J-FDA statistical data, HAI data.

12. HAI data analysis In 2006 New age groups were covered by MOH insurance: Population 0-6 years: 901,000 22% of population Population > 65 years: 240,000 Ref: Jordan Department of Statistics

13. 2007 Ref: Jordan Department of Statistics

14. 2007 • Insured Jordanians before addition of new age groups: 82% • New age groups insured: 4.1 % (0-6 & >65) • Total insured Jordanians : 86.1 % (of total population including visitors) • Total insured Jordanians : 93.3 % (of total population Excluding visitors)

15. HAI data analysis • Although Jordan is classified as a developing country ,yet its medical services are up to the standard of developed countries. • Leader in MENA in health services. • High caliber of medical professionals. • State of the art facilities and services. • Continuous education.

16. HAI data analysis • IVF : leading centers globally. • Open Heart Surgeries • Cancer treatment

17. Situation in Jordan. • The Pharmaceutical Industry is highly advanced in branded generics, ranked 2nd in export. • Over 8000 well trained employees. • Exports over $ 400 mill. • Local market share: 25-30% ( value). • Compared to EU generic % in their local market Germany 21% value • UK 18% value • Denmark 35% Value • Spain 3,3% value • Ref: EU generic manufacturing Association

18. Situation in Jordan. • Insurance covers: • Cancer Treatment 100%. • Kidney Dialysis. • Multiple Sclerosis (MS) • Vaccination of all children100%. • Thalassemia. • HIV, AIDS.

19. Jordan expenditure is moderate Moderate

20. Jordan out of pocket is far less than 18% Jordan, less than 6.7%

21. Our main goal is: • Safety. • Quality • Efficacy. • Availability. • Affordability.

22. Stakeholders

23. Recommendations to enhance branded generics • Government: • Support the procurement policies • Cancel import duties and VAT. • Establish proper guidelines & protocols for dispensing medicines.

24. Recommendations to enhance branded generics • Government: • Run cost effective studies for therapeutic classes. • Upgrade networking of insured population to avoid duplication of dispensing medicines. • Continuous proper training of MOH medical health providers. • Speed up registration of reliable generic pharmaceutical manufacturers, emphasizing: Safety, Quality, Efficacy.

25. Recommendations to enhance branded generics • Physicians: • Encourage physicians to prescribe generics. • Consumers: • Improve awareness towards efficacy and availability of generics.

26. Recommendations to enhance branded generics • Pharmacists: • Implementation of Good Pharmacy Practice (GPP). • Implementation of Code of Ethics in medical promotion. • Raising awareness towards counterfeit drugs.

27. In conclusion • We need to: • Provide high quality affordable medicine. • Support Jordan`s mission to promote medical tourism. • Support local pharmaceutical industries. • Encourage availability of new therapeutic medications to match the high level of health services in developed countries. • Raise awareness among health care providers and patients regarding generics.

28. THANK YOU