In Europe, where automatic generic substitution is scarce, generic manufacturers have to invest substantial sums to persuade doctors to prescribe their generic versions, and also to persuade pharmacists to stock their products. As a result, the generics business in Europe is quite capital-intensive, leaving a few big players like Teva and Novartis’ Sandoz in charge.
Unlike biosimilars, which the EU regulates centrally, small-molecule generic drugs in Europe are regulated at the country level, which accounts for the wide variation in penetration rates.
*Estimate from other sources—not cited in above article; in Japan, the small uptake of generic drugs is more cultural than regulatory.
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