On June 30, Fimmg meets the AIFA President, Melazzini

Topic: the auctions between "therapeutically equivalent" drugs which would jeopardize the reimbursement of about 1,500 medicinal products. Especially innovative products and for the chronically ill, in hospital dispensation. In all 2,700 specialties.

"It is an important sign of openness to confrontation what the President of AIFA, Mario Melazzini gave, inviting the national secretary of the union of family doctors Fimmg, Giacomo Milillo, to a meeting to discuss the problems that he had raised in the media in recent months and which risk hindering citizens' access to important medicines”. The national secretary of the Fimmg family doctors union, Giacomo Milillo welcomes the invitation for next June 30, " which will serve to illustrate the serious ethical and professional problems that doctors would face in the event of the application of the Aifa Determina 458/2016 and to discuss the search for a possible collaboration in the field of experimentation of therapeutic plans in general medicine".

The Determination, only suspended for 90 days, is the one that according to the calculations of the Fimmg study center would jeopardize the reimbursement of about 1,500 medicinal specialties. Above all, innovative products for the chronically ill, dispensed in hospitals, distributed directly or "on behalf", i.e. purchased at discounted prices by the local health authorities and then distributed in pharmacies. In all 2,700 specialties, over half of which risk becoming the responsibility of the assisted due to which the Determination gives the green light and which would leave only the products that will beat the lowest prices within the sphere of reimbursement, excluding all the others belonging at the 4th level of Atc classification. Level that includes drugs with the same therapeutic indication but also with different active ingredients.

"Between the drug that will have beaten the lowest price and those that will instead be excluded from reimbursement, there seems to be no difference, however the damage for the patients will certainly exist", warns Milillo, who also explains why. “Considering that this of the tenders for therapeutic equivalence would be an all-Italian anomaly in the European panorama, it cannot be said that it is sufficient for drugs to belong to the same ATC class to have the same efficacy on the individual patient, who responds differently even if he ingests the same molecule in sachets instead of pills, let alone if the active ingredient is really different”.

“Il provvedimento – spiega il Segretario nazionale del sindacato dei medici di medicina generale – è stato sospeso fino al 27 agosto da una nuova determina della stessa Aifa, ma l’allarme resta alto visto il pressing delle Regioni. Per questo chiediamo al Presidente dell’Aifa di ritirare in toto la Determina sulla gare per farmaci equivalenti”. “E l’incontro – prosegue – sarà l’occasione per sollecitare anche l’avvio della sperimentazione che avrebbe dovuto consentire a 2.400 medici di famiglia di prescrivere i medicinali sottoposti a piano terapeutico, che costringono oggi  10 milioni di malati cronici e gravi a una corsa ad ostacoli per ottenere la prescrizione. Con tanto di pagamento del super-ticket da 50 euro per la visita dello specialista, unico autorizzato al momento a prescrivere”. “Inerzie – conclude Milillo – che stanno creando gravi disagi agli assistiti e che limitano l’autonomia prescrittiva del medico”.

Fimmg – Rome, 28 June 2016

Related news: Determines AIFA 458/2016

AIFA Resolution n. 204/2014

Determine Aifa and drug reimbursement risk: Melazzini and Milillo compared