Intercambialidade de medicamentos: abordagem clínica e o ponto de vista do consumidor

Abstract

The rational construction of an essential drug list, considering the patient's need, drug safety, availability and the best cost-benefit ratio, is based on drug safety, efficacy and quality. However, in daily practice, the prescriber's decision is mostly influenced by drug effectiveness, following criteria that increase adherence to the treatment, such as relative drug toxicity, convenience, cost and prescriber's experience. In addition, frequent launching of new molecules for the same therapeutic indication, together with wide publicity targeting prescribers, interferes with the decision-making process. Similarly, the bonuses offered by the industry for over-the-counter drug sales interfere with the consumer's choice. The confrontation between known human biological variability and the knowledge that there is no absolute similarity between drugs of the same therapeutic class, or even generic drugs, has an impact on the prescriber's drug list, which should include the concept of first and second choice drugs. Prescribers' unfamiliarity with these subjects is a determinant factor for irrational drug use: a public health issue. The objective was to introduce to drug prescribers information that can help them building up a rational drug list for their patients, based on the National Health Surveillance Agency (Anvisa) experience of drug regulation.

Perception of the value of generic drugs in São Paulo, Brazil

“…Of the total health expenditure in Brazil, 53% is private, much higher than the 41.1% global average 1 Generic drugs were approved in Brazil in 1999 under Law n. 9.787/1999 3 , and may be marketed if equivalent to the reference product and produced to the Brazilian National Agency for Sanitary Surveillance (ANVISA) quality standards 4,5 . Generic drugs prices must be 35% below their respective reference prices 6 .…”

<b>Aquisição de medicamentos genéricos em município de médio porte</b>

“…For non-oral medications and non-prescription oral medications, therapeutic equivalence is proven by in vitro test for pharmaceutical equivalence. 13 A study evaluating regulatory trends of generic medications in 14 Latin American and Caribbean countries described the most common regulatory aspects of generic medication policy. It is mandatory to use the INN on labels (in 13 of 14 countries), make public sector prescriptions with the INN (12 of 14) and undertake public sector procurement processes with the INN (11 of 14).…”

“…11 Different explanations for the predominance of the brand name similar medicines in public purchases may include problems in fulfi lling the legislation, lack of interest by generic providers to participate in public purchases and offer of better prices for brand name similar medications. 13 What differentiates the generics from the brand name similar medicines is bioequivalence with the innovator medicines and not good manufacturing practices or intrinsic quality, which are required for all medications. 6 The brand name similar medicines existed before the Generics Law and are copies, which beginning in May 2003 should assimilate as generics by presenting the same tests when renewing registration.…”

“…By October 2014, all additional oral use therapeutic medicines classes will have passed the same tests. 13 Even given these changes, similar medications are viewed with skepticism by managers, health professionals and patients. Studies performed in Brazil show quality problems in part of these medications.…”

Assimetria De Informação Nas Relações Entre Médicos, Pacientes E Farmacêuticos: Impactos Na Prescrição E Compra De Medicamentos

“…Entretanto, pode ser identificada com frequência a presença do balconista substituindo a função do farmacêutico (RUMEL; NISHIOKA; SANTOS, 2006). Tal situação pode propiciar práticas de substituição de medicamentos que não são intercambiáveis LARA, 2013).…”