There is controversy over the position expressed by the Federation of general practitioners (Fimmg) which has invited family doctors to indicate the wording "non-replaceable" on the prescription of drugs whether it is a branded drug or an equivalent. The Consumer Movement denounces: why do general practitioners show such strong resistance to the equivalent drug? And what interests are really protected? Yet "non-substitutability made citizens shell out over 600 million euros in 2011, just to bring home a designer drug, instead of an equivalent", continues the Consumer Movement, which shines the spotlight on the recent indications arrived yesterday by Fimmg. This, reported the secretary general Giacomo Milillo, invited family doctors “to indicate on the prescription the wording 'non-substitutable', whether it is a branded drug or a generic equivalent. Unless you are professionally certain that the drug can be replaced." The position expressed by the Federation is that "equivalent does not mean identical" and that a patient's response may be different from one drug to another, even if it is specified that it does not want to question the validity of equivalent drugs. However, the position immediately sparked controversy.
A response came from the National Association of Generic Drug Industries (Assogenerics), whose president Giorgio Foresti commented: “It is shocking than in Italy after 35 years of generic drug use around the world, with consumption reaching averages of 55%, and in some countries over 80%, with generalized substitutability, the basic concept of these products, their substitutability, is called into question”.
There reference legislation (the "Cresci Italia") provides that the doctor, when prescribing a drug, informs the patient of the possible presence on the market of equivalent medicines, adding to each prescription the phrase “replaceable with generic equivalent”, or, "not replaceable", in cases where there are specific clinical reasons to the contrary. If the doctor does not indicate the non-substitutability of the prescribed drug on the prescription, the pharmacist is required to supply the generic equivalent medicine at the lowest price, unless otherwise requested by the customer.
