Oskar Ström published a retrospective study in Osteoporosis International analyzing the impact of automatic generic substitution on treatment persistence in 36,433 patients. Between 2006 and 2009, the proportion of prescriptions constituting a generic substitution increased from 10.8% to 45.2%, and the proportion of patients persisting with alendronate treatment for 12 months fell from 66.9% to 51.7%. No difference was observed in persistence with proprietary risedronate during the same period. Poor health outcomes and associated costs should be taken into account in the design and evaluation of policies implemented to encourage utilisation of generic medicines.
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