Equivalent medicines, one in three Italians does not consider them. And economic waste increases
We all know the phrase when we go to the pharmacy to buy an over-the-counter product. “Do you want the original drug or the generic one?” The response of consumers is almost always the same, with the choice of the branded medicine. Indeed, to be precise, a survey carried out by SWG on behalf of Cittadinanzattiva, on a sample of 2500 adult citizens representative of the Italian population, tells us that 1 in 3 Italians has doubts about equivalent drugs, thinking that they are different or less useful than the original ones. In reality the generic drug has the same efficacy, the same dosage, it has the same molecule as the one it comes from.
It stands out for just one particularity: it does not have a patent that expired 10 or 15 years ago like the majority of state-funded medicines (those belonging to class A for example), and is therefore the same copy. Yet i equivalent drugs continue to arouse a certain resistance among consumers, perhaps because the generic attribute is misleading, or perhaps because the doctor who prescribes the prescription most often thinks of drugs and not active ingredients. 20% of the sample listened to by SWG say that the doctor only indicates the brand name drug in the prescription; 36% indicating the active ingredient and the branded drug; only 31% report that the doctor only indicates the active ingredient, leaving the patient the choice between equivalent and brand.
The research by Cittadinanzattiva called “Io Equivalgo” and now in its fifth edition, shows how Italians spend 1.1 billion out of their own pockets to choose the original drug, rather than an equivalent one. However, if there was 100% use of the drug at the reference price, citizens could save on copayments. A figure that places our country at the bottom of the European ranking on the use of equivalents. And which accentuates its negativity if we look at the different behaviors adopted by citizens of the northern and southern regions: in the south, despite a lower average income, the equivalent drug constitutes just 20% of sales, while in the north it reaches 40% of impact on national volumes.
A prejudice probably due in part to bad information. In fact, at the time of purchase almost two out of three Italians (64%) rely on the doctor’s instructions, especially among those over 64 and residents in the north-east, but there is also a certain trust in the pharmacist’s instructions (23% ), especially among young people. However, 47% of the sample said they were inclined to purchase an equivalent drug, 34% the one recommended by the doctor or pharmacist and 19% the brand-name drug.
There is no shortage of examples. The ibuprofen case it is one of the most striking. Although there has been a shortage of this medicine in the past, especially for children, the same manufacturing company provided an alternative. Not considered, however. The same thing happened when a year ago it was the turn of amoxicillin, an antibiotic that became unavailable in the version of the best-known brand, but could also be conceived galenically or with other solutions on the market.
Decisive to increase consumer knowledge and awareness is the intervention of Federfarma (National Federation of Italian pharmacy owners) which, through a circular, recalls the importance of supporting equivalent medicines, continuing not only to recommend them to citizens, but also highlighting its advantages. A task, that of the pharmacist, which must be in line with law 405 of 2001 for which the professional has the duty to replace the prescribed medicine (specialty or generic) with the product (specialty or generic) at the lowest price reimbursed by the SSN after informing the patient.
Even more so, in the equivalents, the active ingredient is the same as the branded product from which it comes and the concentrations in the blood reach similar levels, with a variability that must not go below 85%. However, to find out if there are equivalents to the medical prescription and before going to the pharmacy, the Io Equivalgo app is available. You will be able to learn about the different formulations (granules, tablets, syrup) and the list of drugs on the market, whether they are covered by patent (and therefore branded) or no longer covered (equivalent) organized by price ranges. An easy-to-use and relevant tool to counter Istat data which sets at 9.5% those Italians who are forced to give up medical care precisely because of the excessively high prices of medicines.
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