米国で最も売れている4つの処方薬の市場独占拡大費用の推定

Dongzhe Hong^1,2, S Sean Tu^1,3, Reed F Beall^1,4

¹Program On Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, Massachusetts.

JAMA health forum

|August 22, 2025

まとめ

ジェネリック医薬品の競争が遅れたのは市場独占が拡大したためでアメリカには数十億ドルの損失が引き起こされましたタイムリーなジェネリック薬の利用を促すことで患者や健康保険プログラムに大きな節約ができます

科学分野:

健康経済
医薬品政策
薬の価格設定

背景:

特許で保護された市場独占期間にブランド薬は高い価格で販売されます
独占性を拡大し,ジェネリックの競争を遅らせるために特許の密集のような戦略を採用しています
この慣行は米国における医療費に大きな影響を及ぼします

研究の目的:

4つの最も売れている薬のジェネリック競争の遅延によって引き起こされた米国の過剰支出を推定する.
医薬品価格に対する市場独占権の拡大による経済的影響を定量化する.
ジェネリックエントリーの後の価格経路を分析する.

主な方法:

2014年から2018年の間,ジェネリックの競合薬である4つのベストセラー薬 (イマチニブ,グラティラマー,セレコキシブ,ビマトプロスト) の遡及的連続的横断研究.
商業的な請求書とメディケア受給者からの毎月の薬物支出データ (2011-2021) の分析
分割された線形回帰を用いて,拡張された独占性のない対照的シナリオに対して,観測されたトレンドによる純支出の推定.

主要な成果:

試験薬の市場独占期間は7ヶ月から13ヶ月であった.
拡張された独占権がなければ,ジェネリックの導入後の2年間で純支出は推定35億ドル減少していただろう.
商用プランで19億ドル,メディケア・パートDで16億ドルの節約があった.

結論:

ジェネリック医薬品の適時な利用を促すことで,大きなコスト削減が可能です.
販売量が高い薬の市場独占を避けることは患者と支払者にとって利益をもたらします
ジェネリック医薬品の競争を早めるための政策介入は,米国の医療費削減に不可欠です.

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