2018 Volume 8 Issue 2 Pages 95-102
This study investigated the prescriptions in which generic substitutions ware not allowed by prescribers. Among 75,513 prescriptions received by 233 pharmacies which belonged to Iwate pharmaceutical association during any one week from January to March, 2017, there were 7,926 prescriptions (10.50%) in which generic substitutions were not allowed. The number of drug items that were not allowed to be substituted ware 1,714, and a cumulative total number of drugs were 17,536. 52.70% of them was the brand-name drugs whose generic drugs were available in the market, and 14.86% of them were generic drugs for which particular product names were indicated. Classified by efficacy, cardiovascular agents, central nervous system agents, and digestive organ agents consisted of top 3 efficacies. Regarding reason why generic substitutions were not allowed, “patient’s request” was mostly indicated, then “prescriber’s preference” and “poor disease control or side effect caused by a drug substitution” were also indicated. In order to promote the use of generic drugs, it is necessary to reduce the number of prescription in which prescribers refuse the generic substitutions. For that, it is necessary not only to improve the quality of generic drugs and providing appropriate information about generic drugs but also to reform the prescription issuing system and the medical treatment fee system. Further studies are needed to survey the prescriptions in which prescribers refuse the generic substitution in other areas and to explore the effect of the generic substitution refusal on the use promotion of generic drugs.
