It would be advisable to avoid generic substitution for generic when the prescription involves people over 75 with chronic diseases. It is on this principle that, in Veneto, family doctors are looking for a reconciliation with pharmacists that can overcome the most recent conflicts. The basis should be a draft agreement that Fimmg (the most representative of the general medicine unions) submitted to the Region on May 17 and last Saturday to Federfarma Veneto, taking advantage of the conference organized on the subject in Vicenza. In essence, the proposal provides that the doctor puts the words "non-replaceable" on the prescription when the equivalent is intended for a frail patient, "in particular the elderly over 75". Pharmacists, for their part, should check that the prescribed drug is the one already taken by the patient and respect the doctor's veto, informing him of any critical issues. «The goal» underlines Domenico Crisarà, regional deputy secretary of Fimmg «is to agree on a methodology that takes note of reality: the fact that two generics are equivalent to the same brand does not automatically mean that they are equivalent to each other. And then, in the elderly, compliance requires extreme attention when replacing the cans". A cautious opening from the pharmacists: «We will evaluate the Fimmg proposal in the board» replies the president of Federfarma Veneto, Marco Bacchini «for now I can only say that we share the opportunity to forge closer relationships with doctors in the assistance of fragile patients» . In any case, for Bacchini the position of family doctors on the subject continues to be affected by old preconceptions that are now outdated. «They suspect that the substitution in the pharmacy is driven by purely commercial conveniences» he says «but the margins are such that the space for this type of operation hasn't been there for some time. Instead there are choices that derive from the need for careful management of stocks, but even in this case it seems to me that doctors tend to exaggerate: there are now no more than five or six brands nationwide».
Pharmacist33 – June 1, 2011
