E-DRUG: Same tablet and company but different name (4)
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dear E-druggers,
In France though prescribers still prescribe in brand names and generic
use is still low compared to the UK or Denmark or Germany, the
government introduced last year a series of changes in medicine
reimbursement, where medicines prescribed by their generic
names are reimbursed at the cheapest rate available in the market.
So if a patient is supplied with a "branded generic" which costs more, he
or she will have to pay the difference (instead of having full coverage from
the government). Apparently it encourages patients and pharmacists
to be vigilant in using the cheapest generic preparation available.
Perhaps someone else could comment on this in more detail.
In Malaysia with the adoption of electronic prescribing, government
hospitals and especially university hospitals encourage full generic
prescribing (though you can search in brand names on the electronic
prescribing program). With a big generic manufacturing market, we also
often get different physical presentation and brand names for the same
generic equivalent, so from a pharmacist's perspective we often use
generic names when counseling patients, and all pharmacy labels
and hospital prescriptions are in generic naming, so that the
patient does not get too confused. They are also made aware of the
difference in generic and brand naming (we show them how to
differentiate the brand and generic name on the boxes for example),
so that they know it's the same drug even if the boxes or the tablets
themselves are of different colours from time to time!
Since in encouraging generic usage and prescribing it is inevitable
that presentations of generic drugs will vary from manufacture to
manufacture, with or without parallel imports, it is important to
educate the public about it. Through personal experience, I would
say that generic prescribing introduces less errors, and forces
pharmacists and pharmacy dispensers to be more vigilant as
we can no longer be complacent with physical presentations
of tablets or packaging. It is now necessary to recheck labels
and recheck prescriptions before dispensing, which is actually
a good thing in the end. Patients also become more empowered
as they are made more aware of exactly what they are taking
in terms of pharmacological generic names of their medicines.
In my experience with international humanitarian work, where
medicines are purchased or donated in all kinds of brand/generic
packaging and names, it's absolutely essential that generic
prescribing be the norm to avoid the errors mentioned by
Stein where even branded medicines are marketed under
different brand names in different countries. Since most international
NGOs have volunteers with diverse prescribing backgrounds,
generic prescribing seems to me the only solution.
Kae Ting Trouilloud
Pharmacist
kaecherie@yahoo.co.uk
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