||Generic Dispensary Service
Generics, Bioequivalence and Our Dispensary Service-
Demand for our dispensing service is very high!
January of 2017 our
interest poll for using our generic dispensing
program included approximately 58 respondents. This last March we filled 256 separate prescriptions. The staff will agree this has become a significant part of our daily tasks and services for our patients. I am sure many of the readers have seen my
revealing how suddenly everyone is figuring out we are getting scammed on generic prices when using our insurance companies or Medicare part D to help us pay for our medications.
Several factors led to my decision to offer this value added service to the practice including: efficiency, reduction of delays in medication use, the desire to maintain control of my prescribing preferences (experience) and very importantly - saving patients money and time!
I recently read a good article reviewing the issue of equivalence between generic medications and name branded products. In order for a generic equivalent product to be approved for sale in the US market,stringent requirements must be met for the medication to be deemed bioequivalent. The rate and extent of absorption of the generic product must be closely similar to the reference name brand product. Essentially to meet this criteria the generic medication has to stay within the range of peak and total bioavailability of the name brand with a 90% confidence interval throughout the total time of absorption. This is both a reasonable and high standard.
Whenever we start a new medication, generic or otherwise, the clinical outcome should be consistent with this background of bioequivalence. This is why we document our vital signs and measure relevant labs when monitoring treatment plans.
I see no reason for us not to continue to use and benefit from the generic dispensing program. Is is so refreshing for the doctor and the patient to be in the driver's seat of medication use and preferences. Leaving the insurance system out of this decision process allows continuity of treatment and avoids the unforeseen costs and outcomes of forced medication changes. Historically these generic changes are requested simply to improve profitability for the insurance companies.