Research Division for Development of Anti-Infective Agents, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan.
J Infect Chemother. 2012 Aug;18(4):421-7. doi: 10.1007/s10156-012-0437-0. Epub 2012 Jun 9.
Generic drugs have been used extensively in many developed countries, although their use in Japan has been limited. Generic drugs reduce drug expenses and thereby national medical expenditure. Because generic drugs provide advantages for both public administration and consumers, it is expected that they will be more widely used in the future. However, the diffusion rate of generic drugs in Japan is quite low compared with that of other developed countries. An investigation on generic drugs conducted by the Ministry of Health, Labour and Welfare in Japan revealed that 17.2 % of doctors and 37.2 % of patients had not used generic drugs. The major reasons for this low use rate included distrust of off-patent products and lower drug price margin compared with the brand name drug. The generic drugs available in the market include external drugs such as wet packs, antihypertensive agents, analgesics, anticancer drugs, and antibiotics. Among them, antibiotics are frequently used in cases of acute infectious diseases. When the treatment of these infections is delayed, the infection might be aggravated rapidly. The pharmacokinetics-pharmacodynamics (PK-PD) theory has been adopted in recent chemotherapy, and in many cases, the most appropriate dosage and administration of antibiotics are determined for individual patients considering renal function; high-dosage antibiotics are used preferably for a short duration. Therefore, a highly detailed antimicrobial agent is necessary. However, some of the generic antibiotics have less antibacterial potency or solubility than the brand name products. We showed that the potency of the generic products of vancomycin and teicoplanin is lower than that of the branded drugs by 14.6 % and 17.3 %, respectively. Furthermore, we confirmed that a generic meropenem drug for injection required about 82 s to solubilize in saline, whereas the brand product required only about 21 s. It was thought that the cause may be the difference in size of bulk particle and amount of solubilizer. The Japanese government hopes to increase the diffusion rate of generic drugs (in terms of quantity) from 20.2 % in 2010 to 30 % or more in 2012, and therefore it will be necessary to clarify the advantages of generic antibiotics in terms of expenditure and equivalency with the branded drugs.
在许多发达国家,仿制药得到了广泛应用,而日本对仿制药的使用则受到限制。仿制药可以降低药品费用,从而减少国家医疗支出。由于仿制药对公共管理和消费者都具有优势,预计未来它们的使用将更加广泛。然而,与其他发达国家相比,日本仿制药的普及程度相当低。日本厚生劳动省对仿制药进行的一项调查显示,17.2%的医生和 37.2%的患者没有使用仿制药。造成这种低使用率的主要原因包括对非专利产品的不信任,以及仿制药与品牌药相比价格差距较小。市场上的仿制药包括外用湿包、降压药、镇痛药、抗癌药和抗生素等。其中,抗生素在急性传染病的治疗中经常使用。如果这些感染的治疗被延迟,感染可能会迅速恶化。最近的化疗采用了药代动力学-药效学(PK-PD)理论,在许多情况下,会根据肾功能为每个患者确定最合适的抗生素剂量和给药方案;对于短期治疗,通常会选择高剂量抗生素。因此,需要一种高度详细的抗菌药物。然而,一些仿制药的抗菌效力或溶解度比品牌产品低。我们发现,万古霉素和替考拉宁的仿制药的效力比品牌药物低 14.6%和 17.3%。此外,我们证实一种通用的注射用美罗培南药物需要大约 82 秒才能在生理盐水中溶解,而品牌产品只需要大约 21 秒。原因可能是散装颗粒的大小和增溶剂的用量不同。日本政府希望将 2010 年 20.2%的仿制药普及率(数量)提高到 2012 年的 30%或更高,因此有必要从支出和与品牌药物等效性的角度阐明通用抗生素的优势。