E-drug: Generic substitution (cont'd)
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Generic substitution for drugs is widely practised in the UK in order to
trim healthcare costs. From my experience in many cases generic
switching can cause potential problems:
a. In patients stabilised on drugs having a narrow therapeutic index;
b. When generic drugs are registered they must contain identical
amounts of active substances, but binders and fillers are allowed
to differ - these are assumed to be inactive - in my experience this
has caused some problems in sensitive patients;
c. Because of a variety of generic drugs in the market there are
repeated switches. Different brands being provided to the patient
is confusing for many patients.
In my opinion a GP should indicate brand item where a problem is
likely to occur e.g. drugs with a narrow therapeutic index, switch by
pharmacist to generic or parallel import should be done after careful
consultation with patient.
Dr Ketan Varia
Business Consultant Pharmacist
UK
e-mail: ketanvaria@aol.com
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