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Background: Health care related expenditure is increasing with a rapid pace in which much proportion of expenses is on medicines. The expenditure can be reduced by prescribing generic medicines (Janaushadi). In India less prescription of generic medicines can be correlated to less knowledge. Hence this study was carried out among Interns who will be future practitioners to know their perception and practice about generic medicines. Objectives: To assess the Knowledge, Attitude and practice of Interns regarding generic medicines. Methodology: A cross sectional study was carried out among Interns using a pre-tested semi structured questionnaire containing questions related to their Knowledge, Attitude and their practice regarding generic medicines. Data was entered in MS Excel and analysed using SPSS version 20. Descriptive statistics were used. Results: Among the study participants, majority (90%) knew the correct meaning of the generic medicine. 97% of them felt that generic medicines can be prescribed instead of branded medicines. Majority (92%) of the study subjects felt that there should be one Janaushadi (generic medicines) store at every government hospital. Not many (19%) were aware of the law in India for prescribing generic medicines but majority (87%) knew about the Janaushadi Scheme of Government of India. 87% of the Interns had prescribed generic medicines to patients and among them they (85%) felt that generic medicines are easy to prescribe than branded medicines. Conclusion: This study showed that the Interns have good perception regarding generic medicines. Minor proportion of the study participants knew about the law in India for prescribing generic medicines. Majority of the participants have prescribed generic medicines to patients and felt that it is easy to prescribe generic medicines.
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Background: Prescription pattern monitoring studies are tool for assessing the prescribing, dispensing, and distribution of medicines prevailing in a particular area. The main aim of such studies is to facilitate rational use of medicines. Irrational prescribing leads to increased incidence of adverse effects, drug interactions, and emergence of drug resistance. Aim and Objectives: This study aims to evaluate drug prescription pattern of outpatient department patients as per the drug use indicators developed by the World Health Organization (WHO) and also the occurrence of different medication errors. Materials and Methods: 662 prescriptions were evaluated. The WHO core drug prescribing indicators analyzed were Average number of medicines prescribed per patient encounter, percentage of medicines prescribed by generic name, percentage of encounters with an antibiotic, injections, or fixed-dose combination (FDC), score of generic prescription, and justification for the use of brand names. The categories of prescription errors which were studied were legibility, absence of doctor identity, diagnosis, drug dosage, and duration. Results: The most common medication error was lack of treatment duration (75.1%) and illegibility of the prescriptions (61.9%). Most of the drugs were prescribed in generics. About 72.5% of the prescriptions had 100% generic score. Although the use of brand names was not justifiable in most cases. The use of injectables, antibiotics, and FDC was 0.9%, 46.5% and 76.8%, respectively. Conclusion: Such studies should be done regularly to evaluate the lacunae in drug prescribing patterns and improve them.
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Coronavirus pandemic has brought forth the urgency of providing affordable health care to everyone. Generic medicines are often one-fourth to one-tenth of the cost of the branded drugs, and so offer a remarkable opportunity to significantly lower the health-care expenditure. However, the argument for promoting generic medicines is indisputable, we have to think about the other enabling conditions which are necessary for a successful health policy on encouraging generics without causing unintended adverse repercussions. This paper attempts to answer such questions by considering the motivations of the various stakeholders of the broader health services ecosystem in India and undertaking a systematic analysis of the winners and losers from such a policy. We argue that generic prescription will not be successful without prior improvement in the state capacity for quality control of drug manufacturing; rise in awareness among the doctors, patients, and pharmacists; improved trust in the medical systems; and innovative demand-side interventions.
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Objective To analyze the impact of “4+7” City Drug Centralized Procurement Program on the utilization of cardiovascular medicines, and to provide a reference for optimizing the policy of generic medicines as substitutes for original medicines. Methods Eleven drugs, both generic and original were selected for treatment of cardiovascular diseases in an outpatient clinic of a tertiary hospital in Shanghai. The proportion of use of generic drugs and original drug, ratio of used amount, daily cost ratio, and potential cost savings rate of replacement of original drug by generic drug were analyzed before the “4+7” (2018.04.01-2018.09.30) and after the “4+7” (2019.04.01-2019.09.30). Results After the “4+7”, the proportion of the original research drug used decreased from 84.32% to 58.12%, and the ratio of amount of used money decreased from 86.02% to 78.16%; the proportion of generic medicines used increased from 15.68% to 41.88%, and the ratio of amount used increased from 13.98% to 21.84%; the daily cost ratio of generic medicine to original medicine decreased from 0.87 to 0.39. Under the same condition, the potential cost savings of replacing the original drug with generic drugs before and after the “4+7” were RMB 3.703 million and RMB 3.399 million, respectively, and the cost saving rate was 35% and 61%, respectively. Conclusion The “4+7” City Drug Centralized Procurement Program significantly increase the use of cardiovascular generic drugs and significantly reduce the cost of drugs; however, it has a small impact on the quantity and amount of generic drugs used. There is still a significant potential for cost saving. It is recommended to further increase the publicity of the policy on the substitution of original drug by generic, expedite the consistency evaluation process of generic drugs and take measures to avoid the widening of the price gap between original drugs and generics.
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Resumo O objetivo do estudo é analisar a evolução do preço do tenofovir (TDF) no Brasil à luz das diferentes iniciativas para sua redução. Os critérios para a seleção do caso foram: ter sido objeto de pelo menos uma estratégia de enfrentamento da barreira patentária, que no caso foi o subsídio ao exame do pedido da patente (oposição à patente); e ter sido objeto de uma Parceria para Desenvolvimento Produtivo (PDP) para produção local. Os principais resultados sugerem que os subsídios ao exame apresentados em 2005 e 2006 contribuíram para a decisão de indeferimento do pedido de patente em 2009. Estima-se que o Brasil pagou cerca de US$ 200 milhões a mais pelo monopólio gerado a partir de um pedido de patente pendente. Houve uma redução do preço do TDF entre 2003 e 2013, inclusive durante a vigência da PDP (2011 a 2013). Em 2010, após o anúncio da PDP, também houve uma diminuição de 40% no preço do TDF ofertado pela Gilead, que refletiu no preço de oferta do produto PDP. No entanto, o preço pago no Brasil para o produto nacional foi cerca de dez vezes mais caro que o genérico ofertado internacionalmente.
Abstract This study aimed to analyze the evolution of the price of tenofovir (TDF) in Brazil considering the different initiatives for its reduction. The selection criteria for the case were: to have been subject to at least one strategy to overcome patent barrier, which in the case was the support to examination of the patent application (patent opposition); and have been subject of a local production Partnership for Productive Development (PDP). The main results suggest that patent opposition presented in 2005 and 2006 contributed to the decision to reject the patent application in 2009. Brazil is estimated to have paid around US$ 200 million more for the monopoly due to the patent pending application period. There was a reduction in the price of TDF between 2003 and 2013, including during the PDP (2011 to 2013). In 2010, after the PDP announcement, there was an additional 40% decrease in the price of the TDF offered by Gilead, which reflected in the price offered by the PDP. However, the price paid in Brazil for the national product was about ten times higher than the generic offered internationally.
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Humans , Acquired Immunodeficiency Syndrome , Anti-Retroviral Agents/economics , Drug Price , Drugs, Generic , HIV , Patent , Tenofovir , Unified Health SystemABSTRACT
<b>Background: </b>Because generic medicines reduce the financial burden on patients and medical insurance providers, they become more popular year after year. However, there are still few reports that analyze the efficacy and safety of generic medicines, especially in terms of their characteristics and side effects.<br><b>Methods: </b>Paclitaxel is an antineoplastic frequently used with good results in the treatment of breast cancer, ovarian cancer, gastric cancer, and angiosarcoma, but fat solubility is high and various kinds of adverse events, such as myelosuppression and arthralgia, peripheral neuropathy, and alcohol hypersensitivity are known to develop. We investigated the efficacy, characteristics, and the incidence of adverse events for the generic product of paclitaxel.<br><b>Results: </b>Differences were found for the generic version in terms of the characteristics and preparation time.<br><b>Conclusion: </b>The incidence of adverse events was not significant, suggesting that the generic version could be a reasonable substitute.
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Background: In surgical patients, a number of drugs are prescribed to prevent post-operative infections and to relieve pain. Therefore, prescription audit should be periodically performed in Department of Surgery to analyze the present scenario of drugs prescribed for the surgical/post-operative patients. This will help us to use the medicines rationally and decrease the adverse effects in surgical patients. The main aim of the study was to evaluate the drugs prescribing pattern in the Surgery Department in Tertiary Care Teaching Institute. Methods: Patients’ prescriptions or case record forms were randomly collected over a period of 1 year from the Department of Surgery at GGS Medical College and Hospital, Faridkot, Punjab (India) for analysis and rationalization. Results: A total of 900 prescriptions was collected and analyzed for drugs used in surgical patients. Average number of drugs prescribed is 4.26. The most commonly prescribed drugs were anti-microbial agents (AMAs), gastrointestinal tract (GIT) related, non-steroidal anti-inflammatory drugs (NSAIDs) and multivitamins and trace elements, and their percentages were 37.90%, 23.36%, 14.14 %, and 9.11% respectively. About 95% drugs were prescribed by non-generic (Trade) names. Drugs prescribed from National Essential Medicines List (EML) and World Health Organization EML were 69.25% and 45.31% respectively. Average cost per prescription per day was Rs. 610/- (INR) or $10.34 USD in a surgical patient. Conclusions: There is a high tendency and frequency to prescribe four and more than four drugs to post-operative patients. Most drugs prescribed were AMAs, GIT related, NSAIDs and Multivitamins and trace elements. There is an urgent need to develop proper prescription writing skills in budding doctors regarding the use of EML/drugs list and generic medicines to reduce the cost of treatment.
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This study aimed to explore the perceptions of Malaysian community pharmacist towards locally manufactured generic medicines. A cross-sectional descriptive study involving entire population (N = 270) of Practicing community pharmacists in the State of Penang, Malaysia was undertaken using a self-completed anonymous mail questionnaire. Responses were received from 48 pharmacists (response rate 17.8%). Majority of the respondents (97.9%) actively dispensed generic medicines in their practice. Only 37.5% of the respondents viewed locally manufactured generic medicines as equal in quality compared to the imported generics from international manufacturers. However, approximately 60% of the respondents agreed that domestic generics are equal in safety and efficacy as the imported generic medicines. About half of the respondents (47.9%) believed that imported generic products need to pass more stringent approval process. Majority of the respondents (68.8%) urged that the Malaysian regulatory authorities should convince pharmacists about the quality of domestic generic medicines. The Malaysian pharmacists have lack of confidence with the generic medicines produced by local pharmaceutical companies.
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Promoting generic competition following patent expiration of innovator product is a key policy strategy in containing rising drug expenditure in both developed and developing countries. However, the effect of this measure on drug prices has not been specifically explored in Malaysia. This paper analyses the potential effect of generic competition on drug prices in the off-patent pharmaceutical market in Malaysia using retail price data of 28 off-patent multisource prescription medicines collected in a national medicines price survey in Malaysia. The relationship between number of registered brands of multisource medicines and their proportional prices was examined. The results show that the mean proportional price decreases as the number of brands increases, Pearson’s r (6) =0.89, p=0.017 and the differences between the mean proportional prices among the various brands was significant, one-way ANOVA, F (5, 22) =3.68, p=0.014). However, further analysis using Tukey’s post-hoc test analysis shows that the price differentials were not significant across all the brands of a given off-patent multisource product. The findings of this study revealed evidence of price lowering effect of generic competition among multisource drug products in Malaysia, though the effect was not observable across all drug brands.
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The aim of this study was to evaluate the quality of five different solid formulations of carbamazepine. The reference formulation was Tegretol® 200.00 mg (Novartis) and the others were: generic formulation of carbamazepine 200.00 mg (National Industry), similar formulation of carbamazepine 200.00 mg (National Industry), and two formulations of carbamazepine 200.00 mg acquired from two different compounding pharmacies. The latter consisted of capsules obtained in Natal, the capital city of the Brazilian State of Rio Grande do Norte. The quality of samples was evaluated through physical and physical-chemical tests, including: weight, diameter, thickness, content, dissolution, disintegration, hardness, friability and moisture. The results of friability analysis showed that all formulations met Brazilian and United States Pharmacopeia (USP) specifications. In spite of having a higher hardness compared to the reference, the generic formulation had a lower disintegration time. This could be associated to the presence of crospovidone in its formulation. Results of this study showed that all formulations had dissolutions which were in accordance with Brazilian Pharmacopoeia specifications, and quality control tests. An exception was found for the similar formulation, which had a hardness parameter that exceeded the USP standard. However, this difference was not significant given the similar formulation's satisfactory disintegration time.
O objetivo desse trabalho foi avaliar a qualidade de cinco formulações de carbamazepina na dosagem de 200,00 mg: medicamento referência Tegretol® (Novartis), medicamento genérico (indústria nacional), medicamento similar (indústria nacional) e cápsulas do mesmo medicamento obtidas de duas farmácias de manipulação da cidade do Natal, RN. Os ensaios realizados foram: peso médio, diâmetro, espessura, teor, dissolução, desintegração, dureza, friabilidade e umidade. Foi observado que nenhuma das amostras analisadas apresentou friabilidade superior ao limite máximo determinado pela Farmacopéia Americana (1,5 por cento). O medicamento genérico, apesar de apresentar dureza superior em relação ao medicamento de referência, desintegrou em menor tempo, o que pode estar relacionado à crospovidona presente na formulação. As amostras analisadas atenderam às especificações da Farmacopéia Brasileira no que diz respeito à dissolução. Em geral, os resultados das amostras A, B, C, D e E foram considerados satisfatórios uma vez que atenderam as especificações farmacopéicas. Embora a apresentação similar não tenha atendido ao padrão USP no que diz respeito à dureza, esse dado não se mostrou significativo, uma vez que o tempo de desintegração foi satisfatório.