Challenges of therapeutic substitution of drugs for economic reasons: focus on CVD prevention

Johnston, Atholl

doi:10.1185/03007990903578462

Cited by 25 publications

(30 citation statements)

References 27 publications

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“…For example, a survey of patients in the UK has shown that over 20% reported that they would be very or extremely concerned if their prescription was changed, even with their doctor's approval. Of these, 40% felt that the new drug was less effective than the branded drug and 30% experienced more or different side effects [24]. In another British study, 46% of patients stated that they were dissatisfied when faced with generic substitution [25].…”

Section: Discussionmentioning

confidence: 99%

“…The majority [96% (95% CI 91-98)] of participating patients confirmed that they had undergone a kidney transplant more than a year ago. In addition, more than two-thirds were taking more than seven medications [44% (95% CI 36-52) were taking between 7 and 9 medications and 27% (95% CI [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were taking more than nine medications]. In addition, 74/147 participants [50.34% (95% CI 42-59)] were highly educated (graduated from college, university or postgraduate) and 73/147 participants [49.66% (95% CI 41-58)] were less educated (graduated from secondary school, vocational training or sixth forms) ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

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A survey to determine the views of renal transplant patients on generic substitution in the UK

Ameri

Whittaker

Tucker

et al. 2011

Transplant International

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Summary Rising healthcare costs promote the generic substitution among patients because it is identifiable costs. A key concern is that patients should be involved in the decision of switching. The aim of this study was to examine renal transplant patients’ views on generic substitution in the UK. A total of 163 renal patients were surveyed using 36 multiple‐choice questions at Barts and The London Renal Transplant Clinic, in the UK. Transplant recipients over 18 years, able to read and write English and willing to fill in the questionnaire were targeted; 84% of patients were conscious of the availability of generic medicines, 70% understood the terms “generic” and “branded” in relation to medicines and 54% were aware of generic substitution practice. However, 75% did not know if they were taking generics and 84% felt that generics are not equivalent or only equivalent sometimes and they were uncertain that generics had the same quality as branded medicines. Moreover, many patients admitted that they would not accept the generic substitution of ciclosporin when become available in the UK. A number of factors such as patients’ education, knowledge, severity of the disease, efficacy of generic medicines and patients’ involvement in decisions regarding their health appear to drive patients’ attitudes towards generic substitution.

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Section: Discussionmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A survey to determine the views of renal transplant patients on generic substitution in the UK

Ameri

Whittaker

Tucker

et al. 2011

Transplant International

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“…Cost containment-driven drug substitution is defined as switching to another drug because it is cheaper [1]. It has two forms: generic and therapeutic.…”

Section: Introductionmentioning

confidence: 99%

Generic and therapeutic substitutions: are they always ethical in their own terms?

2010

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Cost containment-driven drug substitution, whether generic or therapeutic, is defined as switching to another drug because it is cheaper. So far, such substitutions have drawn their public legitimacy from the general belief that they would not compromise the clinical interests of patients and certainly not violate their right to decline them if they did. This article does not enter the debate on whether or not such substitutions must give exclusive priority to the patient's interests and choices in order to be ethical. Indeed, it acknowledges the plurality of views on this matter. It simply argues that when such substitutions involve a cheaper drug that is known to have different effects and side effects, or even a drug whose effects and side effects are unknown, they are potentially deleterious to the patient, and that no competent and well-informed patient would ever consent to them. Such substitutions are thus unethical in their very own terms.

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“…Our observations also support these findings as the effectiveness of the ISS was inferior to the original IS. In other areas (10) 43 (9) 45 (7) 24 (10) of medicine, concerns have also been expressed about the risks associated with switching to non-originator compounds in the absence of adequate clinical testing [34,35]. Because generic and original drugs must demonstrate bioequivalence, one would expect that switching formulations would not be associated with any significant change in everyday clinical practice [36,37].…”

Section: Discussionmentioning

confidence: 99%

The Complete Study of the Switch from Iron-Sucrose Originator to Iron- Sucrose Similar and Vice Versa in Hemodialysis Patients

Rottembourg¹,

Guérin²

2016

J Kidney

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Challenges of therapeutic substitution of drugs for economic reasons: focus on CVD prevention

Cited by 25 publications

References 27 publications

A survey to determine the views of renal transplant patients on generic substitution in the UK

A survey to determine the views of renal transplant patients on generic substitution in the UK

Generic and therapeutic substitutions: are they always ethical in their own terms?

The Complete Study of the Switch from Iron-Sucrose Originator to Iron- Sucrose Similar and Vice Versa in Hemodialysis Patients

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