It risks being boycotted by pharmacies of the territory the decree of the Campania Region which obliges doctors to justify, with a form prepared by the pharmaceutical service, the "branded" recipes prescribed under the reimbursement regime. Approved at the end of May but only released yesterday, the provision of the Region expressly aims to increase the consumption of generics, in order to make savings on pharmaceutical expenditure which, "from the prescriptive appropriateness indicators monitored in the Ts dashboard (health card, ed.)", would exceed 66 million euros.

To achieve the goal, the decree requires the Local Health Authorities bells to align the rates of prescriptions with generics to those of "the most virtuous health authority in Campania". This means, to give some examples, that they must concern a generic 72% of the ddds (defined doses per day) of ACE inhibitors associated with diuretics, 87% of the ddds of angiotensin II antagonists, 82% of the ddds of Hmg CoA reductase, fluoroquinolone ddd 83% and so on.

For this purpose, the regional provision obliges doctors to favor "off patents" in all prescriptions addressed to "naïve" patients, ie when starting a new pharmacological therapy. And to ensure that the provision is observed, it prescribes that in the case of a prescription for a "branded" drug, the doctor must fill in a «Single prescription model» in which to detail the clinical reasons that impose the choice of the brand specialty.

The annoyances, however, are not limited to doctors. In fact, the decree asks local pharmacists to evaluate the arguments provided by the doctor in the "Model" and, in the event of insufficient motivation, to invite the prescriber to integrate the form. Worse still, in the event of a refusal by the latter, the pharmacist should report the case "to his own strategic management, which will proceed to impose (the doctor, ed.) the sanctions envisaged by current legislation". But that's not enough: the decree remains rather smoky on the fate of the recipe in the event of a dispute; the pharmacist is authorized to send it anyway, but there is no explicit indication that guarantees the subsequent reimbursement to the holder.

Hence the letter which, a few hours after publication of the provision on the Bur, the president of Federfarma Campania Michele Di Iorio sent to the commissioner structure of the Region. Not only to have certainties regarding the payment of the drugs dispensed, but also to remember that "pharmacy owners do not want and must not express "censures"" against the "documentary presentations drawn up by family doctors". Put simply, pharmacies will not apply the decree.

AS – Federfarma – 01/07/2015

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Decree 56 on designer drugs suspended: victory for doctors and pharmacists

Decree 56, which required the doctor to fill in a form for the purchase of branded drugs for those patients who do not want the generic, has been suspended.
Ieri si è tenuto un incontro presso la Struttura Commissariale della Regione Campania presenti i sub commissari Morlacco,Cinque ed i rappresentanti sindacali dei medici e dei farmacisti. Spiega il dottor Caiffa, presidente provinciale dello Snami: “In tale riunione sono emerse numerose criticità circa l’applicatibilità di tale decreto pertanto si è deciso di istituire un tavolo di confronto appena sarà nominato il nuovo commissario, per apportare modifiche e giungere ad una soluzione condivisa anche con i Farmacisti della Regione Campania.

Nel frattempo non sarà obbligatorio allegare alla ricetta il modulo unico di prescrizione”. Contro il decreto 56 erano scesi sul sentierio di guerra Michele Di Iorio, presidente di Federfarma e Giusepe Tortora e Saverio Annunziata, dirigenti nazionali del Sumai di Medicina generale.