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Generics, Snami: continuous "wild" replacement in pharmacies and hospitals

Any generic drug remains liable to be substituted for other products, which generates frequent pill swaps and the risk of over- and underdosing. 

Mauro Miserendino – Thursday, 26 February 2015 – Doctor33

«Unfortunately there is no progress: the dance of changing medicine in the pharmacy continues, even for the categories of medicines in which even a small range of difference in the concentration of active ingredient between one product and another can cause damage. Any generic drug remains liable to be substituted for other products, which generates frequent pill swaps and the risk of over- and underdosing.
The only thing that has changed since the Balduzzi law came out is that the doctor now asks the patient if the prescribed medicine is dispensed from the pharmacist». Gianfranco Breccia national secretary Snami explains why his trade union has decided to revive Audita, a series of meetings in the provincial capitals with patients, colleagues and pharmacists, to raise awareness of the consequences of "easy" substitutions.

The project was relaunched in a communicated which takes up the numbers of the Onda Observatory study on women's health, according to which one patient in four has difficulty finding the same drug in the pharmacy that she usually takes and one out of two has been offered a different drug from the usual one in the pharmacy.
«Audita is not against “generics” – explains Breccia – but against substitutions with pills of a different shape and color than the prescribed product, with which it should always be assumed that the patient has stabilized. The replacement during therapy does not take place so much in the pharmacy as after a hospital stay when the colleague changes the name of the medicine which, however, should in fact be "the same thing". For this reason it is appropriate to talk about the problem also between family doctors and hospitals ».
"In the pharmacy we ask our clients to impose themselves in the event of a change, especially when it comes to antiepileptics, antidepressants, antiarrhythmics, categories which depending on the plasma concentrations can give different effects", says Breccia. Which explains how it may be appropriate to be alert in other cases as well.

«Just yesterday I discovered that a patient of mine takes a double dose of statins because they have been replaced but the latter are indistinguishable from the antipressor. Then there is the increasingly rare case of less effective products. Last summer I had three patients with hypertensive peaks because the medicine dispensed at the pharmacy was not as effective as the one I had prescribed and which they were taking previously. Colleagues verify the same trend, that's why Audita repeats itself».

Related news: Are there really no solutions?

Drugs, the people of Pesaro snub the generic ones

The concepts of pharmaceutical equivalence and therapeutic equivalence


The side effects of the new regulation of prescriptions (Bruno Leoni Institute pdf)

Equivalent drugs (SIF Italian Society of Pharmacology, Position paper)

Generic drugs, Osmed: the Italians are starting to convince

Osmed report of the Italian Medicines Agency (Aifa)

Generic drugs - women don't like them better

The generic drug: numbers and dimensions (Assogenerici – September 2014)


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