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

Strategies to improve the acceptance and use of generics.

Jordan Pharmaceutical Association

Dr.Taher Shakhashir

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• Introduction to Pharmaceutical Association.

• HAI data analysis.

• Situation of pharmaceuticals in Jordan

• Generic Strategy proposal.

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1957 - 2007

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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.

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Jordan Pharmaceutical Association

• Number of pharmacies: 1958 employing 3500.

• Number of drugstores: 317 employing 4500

• Number of manufacturing plants: 16 employing 8000

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Jordan Pharmaceutical Association

• 1950 - 1990 : 2559 Pharmacists

• 1991 – 2001 : 5022 Pharmacists

• 2002 – Now : 3102 Pharmacists

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Jordan Pharmaceutical Association

• Males represent: 53%

• Females represent: 47%

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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% !!!!!

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3318

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18MOH

DRMS

RefugeeMissionPrivateInsuranceNo Insurancecoverage

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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.

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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.

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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.

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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

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Populationpercentage�ُEstimated

population 2007 5723000 100

Jordanian citizens 5282300 92.3

Non Jordanians4407007.7

Population age

0 – 6 years101125017.7

Population

over 60 yrs296450 5.2

2007

Ref: Jordan Department of Statistics

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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)

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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.

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HAI data analysis

• IVF : leading centers globally.

• Open Heart Surgeries

• Cancer treatment

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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 marketGermany 21% value •

UK 18% value •

Denmark 35% Value •

Spain 3,3% value •

Ref: EU generic manufacturing Association

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Situation in Jordan.

» Insurance covers:– Cancer Treatment 100%.– Kidney Dialysis.– Multiple Sclerosis (MS)– Vaccination of all children 100%.– Thalassemia.– HIV, AIDS.

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Jordan expenditure is moderateModerate

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Jordan out of pocket is far less than 18%

Jordan, less than 6.7%

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Our main goal is:

• Safety.• Quality

• Efficacy.• Availability.

• Affordability.

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Stakeholders

Government

Pharmacist

Patient

Physician

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Recommendations to enhance branded generics

• Government:

– Support the procurement policies– Cancel import duties and VAT.– Establish proper guidelines & protocols

for dispensing medicines.

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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.

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Recommendations to enhance branded generics

• Physicians:

– Encourage physicians to prescribe generics.

• Consumers:

– Improve awareness towards efficacy and availability of generics.

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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.

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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.

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THANK YOU