Generic medicines: A fundamental pillar for a sustainable and efficient National Health System

• Generic medicines account for 70% of dispensed medicines in Europe but represent only 19% of total pharmaceutical expenditure.
• These medicines generate significant savings for the healthcare system and improve accessibility.
• The new Medicines Law will be key to improving evaluation, transparency, and efficiency within the system.

Madrid, April 7, 2025. How can we move towards a more sustainable Spanish National Health System? What role do generic medicines play in this journey? What challenges does the generic pharmaceutical industry face, and what strategies can be adopted to overcome them? These were some of the key questions addressed during the training session for journalists, “Unfolding Generic Medicines: The path towards a sustainable National Health System”, held at the Madrid Press Association, organized by the National Association of Health Journalists (ANIS) in collaboration with Towa International.

The session was moderated by health journalist and ANIS Vice President Emilio de Benito and featured the participation of Dr. Jaime Espín Balbino, Professor at the Andalusian School of Public Health. Dr. Espín is also an active member of the Health Economics Association (AES) and a Fellow at the University of California’s Department of Economics, as well as a Visiting Researcher/Professor at the London School of Economics, Duke University, and the University of Chicago.

Dr. Espín emphasized the crucial role of generic medicines in improving access to treatments, stating that they «generate savings for the healthcare system while improving accessibility.» He also highlighted that «generics boost market dynamics by introducing competition in sectors dominated by branded medicines, thereby reducing costs without compromising quality, efficacy, or safety, as confirmed by the European Medicines Agency».

Since their introduction in 1997, generic medicines have saved the NHS over €1 billion annually, while in Europe, total savings exceed €100 billion. These medicines account for 70% of dispensed medicines but only represent 19% of total pharmaceutical spending.

One of the key issues discussed during the session was the need to revise Spain’s reference pricing system. This system requires the first generic on the market to reduce its price by 40% compared to the original, which, according to Dr. Espín, has proven to be insufficiently dynamic. He stated, «The reference pricing system needs to adapt to market conditions to ensure that the savings generated directly benefit citizens.» Furthermore, he highlighted that international experience shows that generics generate significant savings for both healthcare systems and patients, and these benefits must be distributed equitably.

Dr. Espín also stressed the importance of prescribing by active ingredient, a measure that has proven effective in Spain in facilitating the dispensing of generic medicines. He emphasized, «Prescribing by active ingredient is essential to normalize the use of generics,» but acknowledged that there is still room for improvement in achieving wider implementation.

Another major topic discussed was the upcoming reform of the Medicines Law, which, according to Dr. Espín, represents «an opportunity to establish a law suited to the 21st century,» with the potential to improve evaluation, transparency, and efficiency. The current pricing model, which is based on the lowest price, raises concerns about supply shortages.

To strengthen the use of generics, Dr. Espín underscored the importance of combining price regulation strategies with awareness campaigns targeting patients, doctors, and pharmacists. He emphasized, «It is essential for the ministries and the national medicines agency to run campaigns informing people that generics are effective, safe, and approved by the same institutions as branded medicines.»