Province-general practitioners agree to cut 1,200,000 euros a year
BOLZANO. Medicines, from January we will change and many patients will be prescribed by their general practitioner a different medicine from the one they were used to. The province and general practitioners have in fact signed an agreement which commits professionals, even with financial incentives, to prescribing generic drugs instead of the (much more expensive) ones still covered by patents. The novelty that will take place in a few weeks aims to save the provincial health service - perpetually short of money - 1 million and 200 thousand euros.
Doctors who manage to achieve their objectives will pocket - on the other hand - incentives that will range from a minimum of 200 to a maximum of 1,200 euros per year. The only ones to respond spadely to the request of the Province (and of the Health Authority) to join the project to promote the use of generic medicines to the detriment of commercial ones, were the doctors enrolled in the Fimmg (Italian Federation of General Medicine). Luigi Rubino, Fimmg provincial secretary, explains in fact that "the criteria of economy can never prevail over the right of citizens to receive the best possible care, according to the well-known principles of professional ethics that we all know well".
But what are the "generics" that many patients will inevitably have to get used to? These drugs arrived by force in Italy with a reform law of December 2001. These are medicines controlled by the Ministry of Health, which according to experts guarantee the same quantitative-qualitative composition and the same bioequivalence as the medicine known with a fancy name (branded), but cost from 20% to 60% less, simply because, since the patent has expired, they can be produced and marketed at lower prices. «I think it is more than legitimate – explains Rubino – where it is possible, to apply cost containment systems but what we contest is the method. You see it is one thing to educate the doctor on the so-called appropriateness of the prescription, another is to sign a protocol that provides incentives, even minimal, but still incentives. Promising cash rewards to health professionals who switch to other drugs effectively means "leading them into temptation".
Indeed, there are many problems. «The first is that some categories of patients (the elderly for example) have been used to their pill with the same name and the box with the same color for perhaps decades. Changing suddenly risks creating confusion. Not only. If as a doctor I verify that that therapy works, then switching to a generic that is never identical to the commercial one can nullify all the work already done. These aspects are very delicate and must be introduced with caution, a company pact is not enough». Do you think it is always possible to replace a "normal" drug with a generic one?
"No, it's not always possible. Let's take an example. We take statins that are fundamental in the treatment of cardiovascular diseases. There are the latest generation ones that are more expensive and are often replaced
