Merli G J, Vanscoy G J, Rihn T L, Groce J B, McCormick W
Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 15261, USA.
J Thromb Thrombolysis. 2001 May;11(3):247-59. doi: 10.1023/a:1011969005756.
Under pressure to provide cost-effective healthcare, many healthcare systems have adopted Therapeutic Interchange (TI) programs-the interchange of therapeutically equivalent but chemically unique drugs-to reduce the total cost of therapy without compromising patient care. To be appropriate and feasible, a TI program for any class of drugs must meet certain rigorous criteria and undergo medical, financial, tactical, and legal reviews. Moreover, once a TI program is implemented, a process to monitor its success should be established. Application of the TI criteria to low-molecular-weight heparins (LMWHs) reveals that a blanket TI program for LMWHs does not appear advisable at this time.
在提供具有成本效益的医疗保健的压力下，许多医疗保健系统都采用了治疗性药物互换（TI）计划，即互换治疗等效但化学结构不同的药物，以在不影响患者护理的情况下降低治疗总成本。要使任何一类药物的TI计划合适且可行，必须满足某些严格的标准，并经过医学、财务、策略和法律审查。此外，一旦实施TI计划，就应建立一个监测其成功与否的流程。将TI标准应用于低分子量肝素（LMWH）表明，目前对LMWH采用统一的TI计划似乎并不可取。
