Medical Tuscany News
IT supplement to the magazine "TOSCANA MEDICA" (registered at the Court of Florence under no. 3138 of 26/05/1983)
Prescription of brand or generic drugs
The Ministry of Health has issued an important clarification regarding the rule contained in the recent decree on liberalization which concerns the prescription of branded or generic medicines. Given that the law establishes that "If the doctor does not indicate the non-substitutability of the prescribed drug on the prescription, the pharmacist is required to supply the generic equivalent medicine at the lowest price, unless otherwise requested by the customer", it is it has been reported that a literal interpretation of the provision could lead one to believe that the pharmacist is required to give the customer (who does not express a different will) the medicine with a generic denomination having the lowest price among medicines of the same composition, even when such price is equal to or even higher than the price of the "branded" medicine indicated as first choice by the doctor. The correct interpretation of the rule cannot disregard the rationale of the rule, the purposes of which are, in all evidence, aimed at promoting the use of equivalent medicines at a lower cost, in cases where there are no specific health reasons, which make it necessary use of the specific medicine indicated by the doctor. When the medicine with a brand name indicated by the doctor on the prescription has the same price as the lowest price among all the other equivalent medicines (both with a brand name and with a generic name), the substitution of this medicine with another equivalent would not find no justification. Substitution would then be in irreparable conflict with the purposes of the law, if the price of the drug specified by the doctor were lower than the prices of all other equivalents. In conclusion, the pharmacist, if the doctor does not indicate the non-substitutability of the prescribed drug on the prescription, is required to provide the customer with the prescribed drug, where this has the lowest price (absolutely or on a par with other drugs ) among equivalent drugs, while if the price of the prescribed drug is higher than that of other equivalent drugs, the pharmacist is required to provide the customer with the equivalent drug (with a fancy name or with a generic name) having the lowest price among all, except for the different will of the customer.
Year XII – n. 4 – 02/02/2012
