ACCF/AHA 2011 Health Policy Statement on Therapeutic Interchange and Substitution

Holmes, David R.; Becker, Jeffrey A.; Granger, Christopher B.; Limacher, Marian C.; Page, Robert L.; Sila, Cathy A.

doi:10.1161/cir.0b013e31822d97d5

Cited by 19 publications

(16 citation statements)

References 70 publications

(69 reference statements)

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“…Healthcare professionals are concerned about switching between asthma drugs because it may negatively affect disease control through low adherence, and incorrect use of aerosol delivery device types [3,8]. In literature, there is evidence that switching has a negative impact on adherence and disease control through changes in color, size, and packaging [9][10][11][12]. Data from a questionnaire study showed that patients who switched asthma medication, more often experienced difficulties using the device (23% vs. 13%), were less likely to be adherent (55% vs. 68%) and were less likely to report being asthma controlled (69% vs. 83%) compared to patients who did not switch [13].…”

Section: Introductionmentioning

confidence: 99%

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study

et al. 2017

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Background: The expiration of patents of brand inhalation medications and the ongoing pressure on healthcare budgets resulted in a growing market for generics. Aim: To study the use of brand and generic inhalation medication and the frequency of switching between brand and generic and between devices. In addition, we investigated whether switching affected adherence. Methods: From dispensing data from the Dutch PHARMO Database Network a cohort aged ࣙ 5 years, using ࣙ 1 year of inhalation medication between 2003 and 2012 was selected. Switching was defined as changing from brand to generic or vice versa. In addition, we studied change in aerosol delivery device type (e.g., DPI, pMDI, and nebulizers). Adherence was calculated using the medication possession ratio (MPR). Results: The total cohort comprised 70,053 patients with 1,604,488 dispensations. Per calendar year, 5% switched between brand and generic inhalation medication and 5% switched between devices. Median MPRs over the first 12 months ranged between 33 and 55%. Median MPR over the total period was lower after switch from brand to generic and vice versa for formoterol (44.5 vs. 42.1 and 63.5 vs. 53.8) and beclomethasone (93.8 vs. 59.8 and 81.3 vs. 55.9). Conclusion: Per year, switching between brand and generic inhalation medication was limited to 5% of the patients, switching between device types was observed in 5% as well. Adherence to both generic and brand inhalation medication was low. Effect of switching on adherence was contradictory; depending on time period, medication and type, and direction of switching. Further research on reasons for switching and potential impact on clinical outcomes is warranted.

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Section: Introductionmentioning

confidence: 99%

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study

et al. 2017

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“…Generic substitution is the practice of switching from a prescribed originator medicine to an interchangeable generic medicine containing the same active ingredient, dosage form, strength at the time of dispensing [1]. Generic medicines are generally marketed under the non-proprietary name or could be marketed as branded generics [2], as in the case of Jordan where 97% of generic medicines are branded [3].…”

Section: Introductionmentioning

confidence: 99%

Evaluating patients’ perceptions regarding generic medicines in Jordan

El‐Dahiyat

Kayyali²

2013

J of Pharm Policy and Pract

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ObjectiveThe aim of this study was to explore Jordanian patients’ perceptions toward generic medicines and to evaluate their opinions regarding generic substitution.MethodA cross-sectional descriptive study involving Jordanian patients was undertaken, using a self-administrated anonymous questionnaire. The response rate was 80% (n=400/500).ResultsThe study showed that cost of medicines is high according to 83% of the patients. Most patients (92%) preferred to be prescribed the cheapest medicine. Majority of patients (79%) believed that cost should be considered before a drug is prescribed. Most patients (78%) accepted generic substitution and believed that it can provide significant saving. Surveyed patients (78%) agreed that they should have the option of choosing between generic and originator and 74% believed that physicians should give them that choice. These results showed a significant statistical correlation with the monthly income of the patient, percentage cost they pay and number of medicines prescribed (P<0.05).ConclusionThe high cost of medicines in Jordan is believed to be the main driver for choosing generic medicines Furthermore; patients have positive attitudes towards generic medicines. The involvement of patients in the treatment decision would result in more adherence and improvement in health. The insights gained from patients in this study will be useful to health organisations and policy makers to design a robust generic policy to use medicines cost-effectively in Jordan.

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“…amitriptyline, nortriptyline). 13,18,20,21 Therefore, many countries have produced evidence-based guides to ensure that GS is appropriate. One of the examples is the "Approved Drug Products with Therapeutic Equivalence Evaluations", commonly known as the Orange Book, 19 which is a useful guide for pharmacists and other healthcare professionals as regards therapeutic equivalence and approved generic medicines in the US.…”

Section: Generic Substitution As a Methods To Promote Generic Medicinesmentioning

confidence: 99%

Is there a need for a formulary of clinically interchangeable medicines to guide generic substitution in Saudi Arabia?

Alrasheedy¹,

Hassali²,

Aljadhey³

et al. 2013

Journal of Young Pharmacists

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a b s t r a c tThe escalating healthcare expenditure is a major challenge to sustainability of the healthcare systems. To confront the escalating health expenditure in general and medicines expenditure in particular, many countries promoted the use of generic medicines. To promote generic medicines, many countries have adopted a generic substitution (GS) policy and generic prescribing. To effectively implement the GS policy, it is evident in the literature that it is essential to have an evidence-based guide on therapeutic equivalence and formulary of interchangeable medicines to guide responsible GS. In Saudi Arabia, GS is permissive and pharmacists are given the right to perform GS. While the prescriber's approval is not a requirement, patient consent is required when performing GS. Although there are some general drug references, such as the Saudi National Formulary (SNF) and list of registered medicines in the Saudi market, but there is currently no information available to healthcare professionals that documents the therapeutic and bioequivalence between medicines. Thus, it is essential to have a formulary of interchangeable medicines to guide appropriate GS or at least to include such vital information regarding therapeutic equivalence and brand interchangeability as part of the SNF. That, in turn, will not only make healthcare professionals more confident when providing GS, but will also enable the avoidance of situations where GS is inappropriate.

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ACCF/AHA 2011 Health Policy Statement on Therapeutic Interchange and Substitution

Cited by 19 publications

References 70 publications

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study

Brand and generic use of inhalation medication and frequency of switching in children and adults: A population-based cohort study

Evaluating patients’ perceptions regarding generic medicines in Jordan

Is there a need for a formulary of clinically interchangeable medicines to guide generic substitution in Saudi Arabia?

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