Pursuant to the applicable law, the pharmacist must inform about a cheaper alternative to the drug. On the prescription, the doctor may indicate whether the medication prescribed by him should under any circumstances be interchanged. If the pharmacist does not have such information, he should inform about alternative medications.
Pursuant to the Act on the reimbursement of drugs, foodstuffs for particular nutritional uses and medical devices, which has been in force for a year, the pharmacist is obliged to inform patients about the possibility of replacing the prescribed drug covered by the reimbursement with a cheaper equivalent with the same international name, dose, pharmaceutical form, which does not cause therapeutic differences and has the same therapeutic indication.
MARIA RYBKOWSKA, PHARMACEUTIST:
The provision in the act puts the pharmacist in a difficult situation. The question remains whether generics are the same as innovative drugs. I don't think they are identical. But to find out about it, they would have to undergo very expensive and long-term clinical trials - as in the case of innovative drugs.
Sometimes medication cannot be interchanged
One should also be aware that patients can react individually to the substitute and it is difficult to predict this reaction, and this also applies to original drugs. Change medications very carefully. In some situations, this may not be done at all.
Example: I have a patient who buys antiepileptic drugs from me. Last year, the 3-month treatment cost him over PLN 100, in January he was supposed to pay over PLN 400 for the same set. A storm broke out in my head, I found a few cheaper alternatives that I could offer him for less than PLN 20. Despite the large difference in price, the patient did not take advantage of the drug switch.
It turned out that the doctor, when writing a prescription, asked him not to buy substitutes. It was bothering me, so I asked a trusted neurologist with extensive professional experience what was going on. He confirmed the decision, warning me not to , for patient safety , never propose substitutes for neurological drugs, especially anti-epileptic drugs. This applies not only to neurological drugs. The problem is that doctors rarely use itthe possibility of making a mark on the prescription so as not to interchange the medication.
The doctor needs to know the drug has been swapped
I am reminded of a patient who has been buying drugs for a mother suffering from Alzheimer's from us for some time and always asks for a cheaper replacement. In the end, I said that I was giving out the equivalent for the last time, because if the doctor is prescribing a different drug all the time, it means that she does not even know that the patient is taking a substitute. I always inform patients to notify the doctor about the substitution. But as you can see, not everyone does it. The doctor's recommendations should be sacred, we believe in his knowledge, because he knows his patient's he alth better than we do.
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