The Ministry of Health has published for the first time a specific report on the use of generic, biosimilar, and hybrid medicines in the National Health System (SNS), a document that quantifies a reality known by the sector: while hospitals have incorporated these treatments massively, pharmacies maintain a slower and stable penetration, leaving room for improvement in the system's efficiency.
The Secretary of State for Health, Javier Padilla, has highlighted that these medicines are not only a tool to contain pharmaceutical spending but also a key element to guarantee the sustainability of the SNS and increase resilience against supply problems.
Hoy publicamos el primer informe sobre uso de medicamentos genéricos, biosimilares e híbridos en el Sistema Nacional de Salud.
— Javier Padilla (@javierpadillab) July 2, 2026
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Hospitals double the incorporation rate
The report, which analyzes the period 2020-2025, reflects a very marked difference between the two main dispensing channels. In the hospital setting, generic and hybrid medicines represented 63.3% of the units dispensed and 69.5% of the spending in 2025 in markets where alternatives to the original medicine exist. The incorporation is especially rapid: four years after the arrival of a new generic, these products reach an aggregated penetration of 94%.
Biosimilars show even better figures. In 2025, they reached 81.5% of the volume and 78.1% of the spending, with some active ingredients, such as bevacizumab or eculizumab, exceeding 90% market share just thirty months after their commercialization.
Furthermore, the volume of biosimilars used in hospitals practically doubled between 2020 and 2025, increasing from 2.4 to 4.9 million units.
Pharmacies advance at a different pace
The situation changes when medicines are dispensed in pharmacies. Generic and hybrid medicines maintain a stable share close to 60% of the volume —59.8% of units in 2025—, although they only represent 46.1% of the spending. Their implementation speed is considerably lower: five years after their market entry, they barely reach an aggregated penetration of 22%.
In the case of biosimilars, growth is also more gradual. In 2025 they represented 38.6% of the volume, compared to 20.2% recorded in 2020.
Health attributes this difference to several factors, including inertia in prescribing, the absence of automatic substitution in pharmacies, and the clinical preference for maintaining the original treatment in chronic patients.
A tool to sustain the healthcare system
The report emphasizes that generics, biosimilars, and hybrids have the same quality, safety, and efficacy as innovative medicines, but they enter the market once patents expire and do so at a lower cost.
Their incorporation introduces competition, reduces pharmaceutical spending, and, above all, allows for absorbing demand growth without skyrocketing the healthcare budget. According to the Ministry, this saving frees up resources that can subsequently be allocated to financing new innovative treatments.
The report emphasizes that generics, biosimilars, and hybrids have the same quality, safety, and efficacy as innovative medicines
Padilla also highlights another strategic aspect: the diversification of manufacturers. Having several producers reduces dependence on a single supplier and strengthens the system's response capacity in the face of supply crises, such as those experienced during the pandemic.
Hybrids gain prominence
The report includes for the first time a specific analysis of hybrid medicines, a less known category than generics.
These are medicines that start from an innovative drug but incorporate modifications in dosage, route of administration, or application device — as is the case with certain inhalers or eye drops — which prevents them from being marketed as conventional generics.
Health considers these products to be a particularly useful tool in markets where generic alternatives do not exist. For some active ingredients, such as latanoprost or mupirocin, hybrids already exceed 70% penetration.
Large differences between medicines
The document also reveals that implementation is not homogeneous.
While widely used medicines such as metformin or simvastatin show generic shares close to 100%, others such as levothyroxine sodium or salbutamol barely reach 3%, due to clinical restrictions that limit substitution.
Among the analyzed examples, teriparatide also stands out, used to treat osteoporosis, where biosimilars, hybrids, and generics coexist under the same reference pricing system. By 2025, these medicines already represent 88.4% of the market, relegating the original product to a minority position.
In the case of dabigatran, an anticoagulant with a high budgetary impact, the report shows how the volume of generics practically tripled in just one year, driven by the expansion of funded indications.
Differences between autonomous communities
Another aspect highlighted by the Ministry is the significant territorial variability. Padilla points out that the incorporation of these medicines is not uniform among autonomous communities. The most striking example is again dabigatran, where the difference in the use of generics between regions reaches 30 percentage points.
For Health, this data shows that the margin for improvement is no longer found as much in hospitals—where implementation is very high—as in outpatient care. Overcoming current penetration levels in pharmacies appears, according to the report's conclusion, as one of the keys to continuing to guarantee the financial sustainability of the National Health System and maintaining the capacity to incorporate new innovative therapies.