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Health
Tr a c k i n g
M a r k e t Watc h
Authorized Generic Drugs, Price Competition,
And Consumers Welfare
On balance, authorized generics are likely to benefit consumers.
by Ernst R. Berndt, Richard Mortimer, Ashoke Bhattacharjya, Andrew
Parece, and Edward Tuttle
ABSTRACT: The growing frequency of authorized generics has important implications for
the welfare of prescription drug consumers. Authorized generic entry could affect the timing of generic entry, brand-name and generic prices, and generic penetration. We reviewed
19992003 data and found that generic entry in the absence of short-run exclusivity restrictions benefits consumers through lower short-run prices. We suggest that these benefits likely also result from authorized generics. We posit that long-run prices and shares are
likely essentially unaffected by authorized generics and that potential costs to consumers
from any delayed generic entry are likely small. [Health Affairs 26, no. 3 (2007): 790799;
10.1377/hlthaff.26.3.790]
o n s i d e r a b l e i n t e r e s t has focused recently on the effects that authorized generic prescription drugs
have on competition among generic and
brand-name drugs and on consumers welfare. Authorized generics are prescription
drugs whose U.S. marketing approval derives
from the brand manufacturers new drug application (NDA) yet are marketed and sold as
generic versions of the brand.1
Authorized generics can benefit consumers
if they increase competition and lower prices.
However, some argue that the increased shortrun competition they create might undermine
incentives created by the 1984 Hatch-Waxman
Act for generic manufacturers to challenge
patentsincentives designed to foster long-
run competition and earlier generic entry. Although authorized generics likely reduce these
incentives to generic manufacturers, the ultimate impact on consumers through drug
prices and the timing of generic entry is unclear. Here we outline issues and review data
on generic entry between January 1999 and
December 2003 (as authorized generic entry
began to increase), and case studies of authorized generic introductions from 2003 and
2004, to assess the impact of generic entry on
consumers under different market conditions.
Background
n Hatch-Waxman legislation and its aftermath. To foster competition, the HatchWaxman Act allowed generic manufacturers
Ernst Berndt (erberndt@mit.edu) is the Louis B. Seley Professor in Applied Economics, Sloan School of
Management, Massachusetts Institute of Technology (MIT) and National Bureau of Economic Research (NBER),
both in Cambridge, Massachusetts. Richard Mortimer is a vice president of the Analysis Group in Boston,
Massachusetts. Ashoke Bhattacharjya is executive director, Health Outcomes and Policy, Johnson and Johnson
MedicalAsia Pacific, in New Delhi, India. Andrew Parece is a managing principal of the Analysis Group in
Boston. Edward Tuttle is a managing principal of the Analysis Group in Menlo Park, California.
790
M a r k e t Wat c h
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relatively large profits associated with exclusivity (reflecting policies encouraging greater
generic penetration during the exclusivity period and developments in patent law).16
The Federal Trade Commission (FTC) has
reported that of fifty-three ANDA submissions
containing paragraph IV certifications challenged by the patent holder and for which a litigated resolution was reached, twenty-two
(42 percent) resulted in the generic applicants
prevailing at trial.17 Another possible explanation for increased patent challenges is that
patents protecting the brand manufacturers
drugs might have been weaker than in the
past, making such challenges more likely to
succeed. In the context of weak patents, some
argue that settlements (rather than litigated
resolutions), particularly those involving payments by the brand to the potential exclusive
generic entrant (negative fixed fees), are especially harmful to consumers.18
n Extent of generic entry. A sizable literature considers generic entry, brand and generic prices, and generic penetration for traditional small-molecule drugs. One recent study
relies on data from the late 1980s and early
1990s.19 Several other studies examine price
trends and patterns of generic entry; almost all
are based on data ending before or up to the
late 1990s.20
This literature generally finds that having
more generic entrants for a drug is associated
with lower generic-to-brand price ratios and
higher generic shares. However, it also suggests that after the first few entrants, the marginal effect of each entrant on generic prices
and shares tends to be negligible.21
Using a data set on drugs experiencing
more recent generic entry, we found empirical
evidence consistent with these earlier findings.22 Based on 19992003 data, Exhibit 1 documents that the impact of an additional generic is negligible after the fourth or fifth
entrant. Specifically, at twenty-four months
since initial generic entry, only one drug with
fewer than five generic entrants (out of seven)
had a generic-to-brand price ratio below 0.37;
all ten drugs with more than five generic entrants had generic-to-brand price ratios falling
M a r k e t Wat c h
EXHIBIT 1
Generic-To-Brand Price Ratio Versus Number Of Generics, Twenty-Four Months
Following Initial Generic Entry, 19992003
Generic-to-brand price ratio
0.8
0.6
0.4
0.2
0.0
0
10
Number of generics
15
20
SOURCE: Authors analysis based on IMS Retail and Non-Retail Sales Perspective data and IMS Retail National Prescription
Audit (NPA) data for drugs that experienced generic entry between January 1999 and December 2003 and for which data were
available twenty-four months following initial generic entry.
Impact On Consumers
The primary effects on consumers of authorized generic entry relate to the timing and extent of generic entry, through the dynamic impacts of authorized generic entry on generic
share and generic/brand relative prices.
n Timing of generic entry. By increasing
expected competition during the exclusivity
period, anticipated authorized generic entry
reduces expected profits for successful paragraph IV certifications, in turn reducing the
incentives to pursue such certification. For
some drugs, this could delay generic entry if it
resulted in no successful paragraph IV certifications under anticipated generic entry when
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EXHIBIT 2
Drugs Facing And Available For First Paragraph IV Certification, As Of May 2006
Number of drugs facing first certification
12
10
250
225
200
175
150
125
3/04
6/04
9/04
12/04
3/05
6/05
9/05
12/05
3/06
SOURCES: Food and Drug Administration, Paragraph IV Patent Certifications as of January 18, 2007, http://www.fda.gov/
cder/pgd/ppiv.htm (accessed 6 February 2007); and FDA data on new molecular entities (NMEs).
NOTES: Some drugs facing paragraph IV certification may be counted more than once if the abbreviated new drug applications
(ANDAs) containing paragraph IV certifications for different doses of the drug are filed in separate submissions. Stock of drugs
available for certification is the sum of drug approvals between the previous four and twelve years. Data on drugs facing
certification are shown as bars and relate to the left-hand y axis. Data on the stock of drugs available are shown as a line and
relate to the right-hand y axis.
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M a r k e t Wat c h
EXHIBIT 3
Average Generic-To-Brand Price Ratios, With And Without Successful Paragraph IV
Filings, 19992003
With successful paragraph IV filings
Without successful paragraph IV filings
21
22
21
0.2
13
0.0
3
12
15
18
21
24
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EXHIBIT 4
Average Generic Share Of Prescription Units, With And Without Successful Paragraph
IV Filings, 19992003
Generic share (percent)
80
13
7
60
40
21
7
22
21
20
3
12
15
18
21
24
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M a r k e t Wat c h
EXHIBIT 5
Generic Unit Shares For Paxil (Brand), Authorized Generic, And Independent
Paroxetine, 20012004
Authorized generic share
Independent generic share
Brand-name share
0
0
6
8
10
Months following initial generic entry
12
14
16
SOURCE: IMS Retail National Prescription Audit (NPA) data, January 2001 and December 2004.
NOTES: Market shares are based on extended units from IMS data. Numbers on the graphic are the number of independent
generics.
generics, and independent generics are proportionally similar and that the wholesale
price ratios provide reasonable proxies for relative consumer price impacts.35
Concluding Comments
We report evidence consistent with authorized generics benefiting consumers of drugs
sold during 180-day exclusivity periods, by introducing additional competition that places
EXHIBIT 6
Generic (Paroxetine)-To-Brand (Paxil) Price Ratios Versus Number Of Months After
Generic Entry, 20012004
Generic-to-brand price ratio
1.00
0.75
1
0.50
3
2
3
3
12
13
14
15
16
0.25
1
6
8
10 11
7
9
Months following generic entry
SOURCE: IMS Retail National Prescription Audit (NPA) data, January 2001 and December 2004.
NOTES: The generic-to-brand price ratio in the first month is constrained to 1.00 as an apparent mismatch in the timing of
revenues and units results in unreasonable average generic revenue (price) in that month. Prices are calculated monthly based
on revenues and extended units as reported in IMS data. Numbers on the graphic are the number of independent generics.
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3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
http://www.ftc.gov/os/2002/07/genericdrug
study.pdf (accessed 7 October 2005).
Ibid.
An independent generic entrant is a generic entrant whose ability to be sold derives from its
FDA-approved ANDA.
FDA, Guidance for Industry, June 1998, http://
www.fda.gov/cder/guidance/2576fnl.pdf; March
2000, http://www.fda.gov/cder/guidance/3659fnl
.pdf; and July 2003, http://www.fda.gov/cder/
guidance/5710fnl.pdf (accessed 18 August 2006).
M. Freudenheim, All about Generic Pharmaceuticals; Now the Big Drug Makers Are Imitating
Their Imitators, New York Times, 20 September
1992.
Mylan Laboratories, Form 8-K, Citizen Petition,
pp. 1317, 30 June 2004, http://ccbn.10Kwizard
.com/xml/download.php?format=pdf&ipage=
2869681 (accessed 16 March 2007).
M. Sipkof, Battle over Authorized Generics
Grows Increasingly Heated, Drug Topics, 1 April
2005, http://www.drugtopics.com/drugtopics/
article/articleDetail.jsp?id=152726 (accessed 14
September 2005).
U.S. Department of Health and Human Services,
Docket nos. 2004P-0075/CP1 and 2004P0261/CP1, 2 July 2004, http://www.fda.gov/
ohrms/dockets/dailys/04/july04/070704/04p0075-pdn0001.pdf (accessed 24 August 2005).
See, for example, Teva Pharmaceutical Industries v.
FDA, no. 05-5004, U.S. Court of Appeals, D.C.
Circuit, 3 June 2005.
See S. 3695, 109th Cong., 2d sess. (19 July 2006).
D. Reiffen and M.R. Ward, Branded Generics
as a Strategy to Limit Cannibalization of Pharmaceutical Markets, Working Paper, May 2005,
http://www.uta.edu/faculty/mikeward/branded
generics.pdf (accessed 7 October 2005).
See Pharmaceutical Research and Manufacturers
of America, Authorized Generics Can Lead to
Lower Drug Prices, Press Release, 20 July 2006,
http://www.phrma.org/news_room/press_
releases/authorized generics_can_lead_to_lower_
drug_prices (accessed 6 February 2007).
Here we consider a single authorized generic entry, although in principle there could be more.
FDA, Guidance for Industry, June 1998, March
2000, and July 2003.
Grabowski suggests that generic firms are prospecting in patent challenges for very large payoffs
from 180-day exclusivity periods should they be
successful. H. Grabowski, Competition between Generic and Branded Drugs (Unpublished paper, Duke University, May 2005).
FTC, Generic Drug Entry. Of the remaining thirty-
M a r k e t Wat c h
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
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