COMMUNICATED TO SICILIAN COLLEAGUES. Dear colleagues and friends, I would like to inform you of excerpts from a document distributed by assogenerici (an association that includes companies that market generics). In this document, in the chapter concerning the substitutability of the drug in the pharmacy (written by Prof. Minghetti - professor of technology, socio-economics and pharmaceutical legislation at the University of Milan) reports the following analysis: “…since 1 December 2001 (law 405 of 16 November 2001), the pharmacist is reimbursed by the NHS up to the lowest price of the corresponding generic available in the normal regional distribution cycle, on the basis of specific directives defined by the region. The pharmacist, after informing the patient, can replace the prescription by choosing from the medicines included in the aforementioned list. When the doctor prescribes a medicine, for which he does not want the substitution to be implemented, he can put an adequate indication on the prescription; at the time of dispensing, if the prescription indicates that it cannot be substituted or if the patient refuses the substitution, the pharmacist will deliver the prescribed medicine and the difference between the lower price and the cost of the medicine will be borne by the patient. In all other cases, if the doctor prescribes medicines with a higher price than the lowest, the pharmacist replaces the one prescribed by delivering the one with the lowest price. On the other hand, on the basis of the national legislation in force, the substitution between medicines having the same price does not appear legitimate, except for reasons of unavailability of the product. Some regions have provided for specific resolutions to legitimize this possibility as well. The replacement can also be done in an emergency. If what is prescribed cannot be found in the normal distribution cycle or the pharmacy is exceptionally without it, the pharmacist can deliver another medicine, of the same composition and pharmaceutical form, and with the same therapeutic indications, notifying the prescribing doctor, without the constraint of the lower price (Law 14 October 1999, n. 362)."
The fact to underline is precisely that axogenerici itself highlights (read in hand) which are the rules, IN FORCE, which govern the substitutability of the drug at a national level. I'm doing my best, requesting a meeting with the regional councilor and the director of the sector, Ciriminna, to induce him to immediately issue a circular to the general directors of the USL and pharmacists, so that they respect the norm.
Best wishes
Tonino Tilotta
President of AIISF Region of Sicily
member of the Sicilian Region Pharmaceutical Consultation Commission
Best wishes
Tonino Tilotta
President of AIISF Region of Sicily
member of the Sicilian Region Pharmaceutical Consultation Commission
