Generic substitution – issues to bear in mind…

As I wrote in my blog post regarding Animal Testing before lunch today, I am participating in LIF’s two day meeting, ”Flerlänsmöte” at Quality Hotel Winn in Haninge, with Patient Advocacy Groups (PAGs). Today’s discussions have been focused upon generic substitution and the Swedish generic reform. We have met representatives from both the Swedish MPA (Catarina Bernet), and from TLV, the Dental and Pharmaceutical Benefits Agency (Britt-Mari Lidholm and Anna Wollin). Participating in the discussion was also Anders Öhlén from the Pharmaceutical Insurance (”Läkemedelsförsäkringen”).

I have discussed consequences of generic substitution several times before. See e.g. the blogposts from May 3, 2011, or Jan 20, 2011, or Jan 18, 2011. My main message has been that I find it peculiar that government has introduced a system with a mandatory substitition to the cheapest generic product, regardless of other aspects such as environmental impacts from manufacturing.

The PAGs raised more issues with the generic reform, in addition to environmental concerns:

- The risks associated with different colours of substituatable products. Do everybody really understand that a tablet that was pink yesterday should be the same that the blue tablet that is ”product of the month” today?

- The risk for allergic reactions. Remember that it is only the active pharmaceutical ingredient that is the same, excipients etc could differ from one another.

- Some of the generic companies are not part of the Pharmaceutical Insurance (”Läkemedelsförsäkringen”). Can it really be OK that a product that is manufactured by a company that is part of the Pharmaceutical Insurance should be substituted to a product where the manufacturer is not…

The list could be made even longer – there are obvious a number of issues to bear in mind when generic substitution is discussed. Do not only look on the ”money saved to government”, be honest and describe the problematic issues as well.

Just let me to once again present one of the things I do find very strange. If I am a conscious consumer and know which companies that behave responsibly (for instance is part of the Pharmaceutical Insurance and also have a ambitious Corporate Responibility work), why should I be punished when I make my conscious choice? If I do not want the cheap generic that has become ”product of the month” and even not the one my physician has written on my prescription, but another one with the same active ingriedient, I will have to pay the full price. Not only the difference between the price of the ”product of the month” and the price of my product of choice, but actually the full price. Is there any other sector where the system punish the conscious consumer? I do not think so. And it should not be like that in our industry and sector either!


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