In the 2020 presidential election in the U.S., reducing drug price has been one of the major issues in both democratic and republican parties. Interestingly, under the single-payer system in Taiwan, low drug price and poor quality become a concern. A recent study by professor, Dr. Shou-Hsia Cheng and colleagues at National Taiwan University College of Public Health has found that newly-diagnosed diabetes patients prescribed with low-price generic drugs consumed 39 percent percent more dosage compared with those using brand-name drugs.
The majority of previous studies have supported that generic drugs are as good as brand-name drugs. However, in Taiwan and other countries, many patients have a perception that cheaper drugs are less effective although there has been very limited evidence. Dr. Cheng and Ms. Yu-Shiuan Lin, a pharmacist and doctoral student, utilized multi-year claims dada under Taiwanese single-payer system. They selected patients with newly diagnosed type 2 diabetes receiving metformin or sulfonylureas via propensity score matching and examined the cumulative dosage, use of insulin, emergency department visit or hospitalization due to hyper- or hypoglycemic conditions during the first year after initial diagnosis. The results showed that high-price generics and brand-name users received similar dosage of hypoglycemic agents with comparable outcomes. By contrast, low-price generics users received 39 percent more dosage (P<0.001) with marginally poor outcome.
The findings suggest that very low price may lead to poor drug quality. Health authorities should pay attention to quality assurance while devoting their efforts in drug price control.
This article was published in Health Policy in December of 2019.Tags: Friday Letter Submission, Publish on February 14