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Strategies to improve the acceptance and use of generics. Jordan Pharmaceutical Association Dr.Taher Shakhashir • Introduction to Pharmaceutical Association. • HAI data analysis. • Situation of pharmaceuticals in Jordan • Generic Strategy proposal. 2 1957 - 2007 3 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. 4 Jordan Pharmaceutical Association • Number of pharmacies: 1958 employing 3500. • Number of drugstores: 317 employing 4500 • Number of manufacturing plants: 16 employing 8000 5 Jordan Pharmaceutical Association • 1950 - 1990 : 2559 Pharmacists • 1991 – 2001 : 5022 Pharmacists • 2002 – Now : 6 3102 Pharmacists Jordan Pharmaceutical Association • Males represent: 53% • Females represent: 47% 7 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 8 18 21 10 MOH DRMS 18 33 Refugee Mission Private Insurance No Insurance coverage 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: » » » » 9 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. • 2004: HAI data analysis » 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. 10 » Refs: J-FDA statistical data, HAI data. 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. 11 » Refs: J-FDA statistical data, HAI data. HAI data analysis In 2006 New age groups were covered by MOH insurance: Population Population 0-6 years: 901,000 > 65 years: 240,000 Ref: Jordan Department of Statistics 12 22% of population 2007 ُEstimated population 2007 Jordanian citizens Population 5723000 5282300 percentage 100 92.3 Non Jordanians 440700 7.7 Population age 0 – 6 years 1011250 17.7 Population over 60 yrs 296450 5.2 13 Ref: Jordan Department of Statistics 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) 14 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. 15 HAI data analysis • IVF : leading centers globally. • Open Heart Surgeries • Cancer treatment 16 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 • 17 Ref: EU generic manufacturing Association Situation in Jordan. »Insurance covers: – Cancer Treatment 100%. – Kidney Dialysis. – Multiple Sclerosis (MS) – Vaccination of all children 100%. – Thalassemia. – HIV, AIDS. 18 Jordan expenditure is moderate Moderate 19 Jordan out of pocket is far less than 18% Jordan, less than 6.7% 20 Our main goal is: • Safety. • Quality • Efficacy. • Availability. • Affordability. 21 Stakeholders Government Physician Pharmacist Patient 22 Recommendations to enhance branded generics • Government: – Support the procurement policies – Cancel import duties and VAT. – Establish proper guidelines & protocols for dispensing medicines. 23 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. 24 Recommendations to enhance branded generics • Physicians: – Encourage physicians to prescribe generics. • Consumers: – Improve awareness towards efficacy and availability of generics. 25 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. 26 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. 27 THANK YOU 28