09 MAY – They cost less and are equally effective: for this reason the so-called generic or equivalent medicines represent an effective strategy for containing healthcare costs to the advantage of public and private spending sustained by families. But the safety of these medicines, even if established on adults, is it the same even on children? A legitimate doubt, given that the paediatricians gathered at the 69th National Congress of the Italian Society of Pediatrics, specified during the conference that a particular call for caution must be made for these drugs: the objective of saving must not prevail over that of safety , especially in a delicate area such as childhood. Always keeping in mind that “the child is not a miniature adult”, as he explained Giovanni CorsalloSIP President.
In the last four years, thanks to equivalent medicines, the National Health Service has saved approximately 400 million a year (source Assogenerici), a figure destined to grow also due to the effect of the provision on the Spending Review which required the doctor to write the name of the active ingredient on the prescription and which in the case of adult patients has the only effect is that of savings. But this is not necessarily the case in paediatrics, where there is a specific concern regarding the question of dosage: in fact, in generic drugs the law allows a deviation in the concentration of the active ingredient up to 20% compared to the brand name drug. “A variability that is not very significant in adults, but which in children can be the cause of an overdose on the one hand or of ineffectiveness of the therapy on the other”, added Corsello.
Furthermore, paediatricians warn, the problem of sweeteners and additives should not be underestimated, substances with no pharmacological action which serve to guarantee the stability and conservation of the drug. In the generic these ingredients can be different from those used in the 'branded' drug: "These are substances that can give rise to hives-like reactions, sometimes erroneously attributed to the active ingredient but which in reality derive from the excipients", he underlined Roberto Bernardini, President of the Italian Society of Pediatric Allergy and Immunology (SIAIP).
Therefore, the results of the first national study on perception are not surprising and the use of generics by family pediatricians, recently published in the journal Health Policy. "Although the knowledge of generic drugs by Italian pediatricians is absolutely satisfactory, their prescription appears to be limited," he explained Gian Vincenzo Zuccotti, Director of the Pediatric Clinic of the Luigi Sacco Hospital in Milan. “Out of 303 doctors questioned, about 70% dich
