Introduction of generic substitution and reference pricing in Ireland: early effects on state pharmaceutical expenditure and generic penetration, and associated success factors

Background In response to the financial crisis and under the EU/IMF Programme of Financial Support, Ireland committed to make savings on pharmaceutical expenditure, including through a system of generic substitution (GS) and reference pricing (RP) [1]. This intervention involved GS based on fifth level ATC code (active substance), which was followed by RP 3-5 months later. The aim of this analysis was to determine estimates of savings to the healthcare payer resulting from the introduction of GS and RP and to examine utilisation patterns pre and post intervention.