Kairi Jayant Kumar, Sharma Ashok Kumar
Professor and Head, Department of Pharmacology, ESIC Medical College and Hospital, Faridabad, Haryana.
Professor and Head, Department of Pharmacology, Armed Forces Medical College, Pune, India.
J Clin Diagn Res. 2017 Aug;11(8):FE01-FE05. doi: 10.7860/JCDR/2017/28552.10439. Epub 2017 Aug 1.
A very large part of India's population fulfils its healthcare needs from government run healthcare delivery system which is free, contributory or highly subsidised. Use of medicines forms a large part of healthcare facility. As the number of medicines and brands are ever increasing in today's market, it is usual for pharmacy to substitute a generic instead of the prescribed brand or a different brand if the prescribed brand is not available. Depending on the type of substitute, it could fall under 'generic' or 'therapeutic' substitution. For any condition, there may be numerous medicines existing, some of which probably got introduced more recently, may be more expensive and erroneously perceived to act better than the earlier known medications for the same ailment. Also, due to very high number of medicines that are approved and available for use in the market, it is impossible to stock all the medicines in any pharmacy. Generic and therapeutic substitutions should be formalised and implemented by institutions, with the consent and cooperation of all the stake holders as guided by World Health Organisation. The advantages and limitations of medicine substitutes are discussed in the review.
印度很大一部分人口通过政府运营的免费、缴费型或高额补贴的医疗服务体系来满足其医疗需求。药品的使用在医疗设施中占很大一部分。由于当今市场上药品和品牌数量不断增加，药房通常会在没有处方品牌时用通用名药品替代，或者使用不同品牌的药品。根据替代类型，这可能属于“通用名”或“治疗性”替代。对于任何病症，可能存在众多药品，其中一些可能是最近才推出的，可能更昂贵，并且被错误地认为比治疗同一种疾病的早期已知药物效果更好。此外，由于市场上获批可用的药品数量非常多，任何药房都不可能备齐所有药品。通用名和治疗性替代应由各机构在世界卫生组织的指导下，经所有利益相关者同意并合作后正式确定并实施。该综述讨论了药品替代的优点和局限性。
