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Doctor warns against using cheap drugs.

Summary: Drug substitution, or the use of cheaper generic medicine, could pose more harm to patients and potentially drive up healthcare costs if shifting to generics is based on economic grounds alone, cautioned an Emirati pharmacologist.

Drug substitution, or the use of cheaper generic medicine, could pose more harm to patients and potentially drive up healthcare costs if shifting to generics is based on economic grounds alone, cautioned an Emirati pharmacologist.

"Drug substitution is mainly economically driven; it can benefit healthcare services but does not directly benefit individual patients," said Dr Mubarak Nasser Al Ameri, one of the first UAE researchers to receive a PhD in Pharmacoeconomics and with the highest distinction from the London University, UK.

In his PhD thesis, Dr Al Ameri asserted that many healthcare providers in the world have been promoting drug substitution in an attempt to contain their costs, under the presumption that generic drugs are not inferior to the more expensive branded medicines, "and the premise that any saving that does not compromise the quality of care is essentially appropriate."

"However, substitutions become problematic when the cheaper drug is known to have different effects and side effects, or even when there is just uncertainty about such effects," he stated.

Speaking to Khaleej Times about his research, Dr Al Ameri pointed out that safe and effective generic and therapeutic substitution is still possible with quality medicines that fit within the budget.

He noted that with today's increased availability of medicines, the number of quality generic drugs has also increased, offering more choices.

He suggested that prescriptions of generic drugs should only be given to selected patients and for particular diseases, ensuring that the drug won't cause any side effects.

"People mistake bioequivalent as identical to the brands but scientifically, bioequivalent means similar but not the same. We have to find out that they are very much similar to the brands," Dr Al Ameri explained.

He also advises against giving generic drugs randomly and switching among generics, especially in favour of cheaper drugs, as this could potentially result in harmful side effects for the patient.

"Don't be tempted by the cost; what costs less now, will cost more (tomorrow)," he stated.

Dr Al Ameri underscored the importance of the patients in the triangle of treatment -- physician, medicine and patient.

"If physicians decide to give a generic drug to the patient, they should inform the patient and underline the change... ask them to keep track of their health and come back for another visit. There should be education, information and follow-up," he stressed.

To determine the level of generic prescribing in the UAE, Dr Al Ameri collected about 1,000 written prescriptions containing an average of seven medications. With the random samples, he found that generic prescription in the country has reached 21 per cent compared to 83 per cent in the UK.

"The best way to use our allocated budget/resources is through appropriate generic and therapeutic substitution using high-quality generic drugs," he said.

olivia@khaleejtimes.com

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Publication:Khaleej Times (Dubai, United Arab Emirates)
Date:Mar 3, 2013
Words:516
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