E-DRUG: Israel introduces generic drugs scheme
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BMJ 1999;319:592 ( 4 September )
News
Israel introduces generic drugs scheme
Judy Siegel-Itzkovich , Jersusalem
Israeli pharmacists may now substitute cheaper generic versions of
prescription drugs for brand name drugs if the prescribing doctor does
not use the commercial name.
In addition, those working in both private and health fund pharmacies
have been permitted to advise customers on over the counter drugs and
suggest what is most suited to them.
These changes came into effect recently with amendments to the
Pharmacists' Order passed earlier this year by the Knesset
(parliament). The amendments were initiated by the health ministry
director general, Professor Yehoshua Shemer.
If the doctor does not give the commercial name of the drug, the
pharmacist may substitute a generic medication, but only if the
substitute has the same active ingredients, form, and medical effect
as the original. This is expected to reduce the costs to the four
public health funds and the health system in general, said Professor
Shemer, but he did not have figures on how much would be saved.
Pharmaceutical companies did not lobby against the amendments, as the
major companies produce generic as well as branded drugs. "We were
neutral on this," said a senior official of one of Israel's largest
drug firms.
The new rules could help to promote parallel imports of
pharmaceuticals from Europe and other countries, to break the
monopolies of pharmaceutical importers with monopoly rights to a
certain drug.
The changes expand the authority of licensed pharmacists but also put
more responsibility on their shoulders; they can be sued if their
advice is faulty and they harm patients.
Howard Reiss, chairman of the Israel Pharmacists Association,
commented that his organisation had for years been demanding more
responsibility for pharmacists, "who are the greatest wasted resource
in the country." He maintained that 5-8%of all patients in hospital
are there because of taking drugs that interfere with one another or
are contraindicated by their condition and said that each year between
2000 and 2500 Israelis die because of these drug complications.
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