Reasons for patients’ generic drug switching at the pharmacy counter: a pilot study

Category: Original Research
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Keywords: Brand-name drugs, drug switching, generic drugs, generics substitution, interchangeability, pharmacy practice

Author byline as per print journal: Pieter J Glerum1,2, MSc; Mert Hayta1,3, PharmD, MSc; David M Burger5, PharmD, PhD; Cees Neef6, PharmD, PhD; Marcel L Bouvy3, PharmD, PhD; Marc Maliepaard1,4, PhD

Background: Patients may experience clinical discomfort as a result of drug switches between drug products with the same active substance. Although a large market share of generic drugs is financially favourable, reduction of the number of drug switches should be strived for. However, specific causes for the drug switches are currently undocumented.
Objective: To document reasons for patients’ drug switches between drug products with the same active substance.
Methods: Observational field research was conducted in a total of 16 Dutch pharmacies during November and December 2019. In these pharmacies, a single researcher registered reasons for drug switches at time of occurrence, during a full working day.
Results: In total, 207 drug switches were registered. Most drug switches were caused by nationwide drug shortages (32%, n = 66) and the Dutch price-based tender system (23%, n = 47). Other important reasons were as follows: deals between pharmacists and wholesalers (12%, n = 25), distribution issues at wholesalers (11%, n = 22) and a financially favourable margin for pharmacists (11%, n = 21).
Conclusion: This study indicates that drug shortages and the Dutch price-based tender system are likely to be the main causes of drug switches in the Netherlands. However, other reasons, such as drug product distribution issues and local economic incentives, were also identified.

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