Hamada Yuhei, Uchida Masashi, Arai Sayaka, Yamazaki Kaori, Takeda Mariko, Arai Kenichi, Nakamura Takako, Suzuki Takaaki, Ishii Itsuko
Division of Pharmacy, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8675, Japan.
J Pharm Health Care Sci. 2020 Dec 4;6(1):27. doi: 10.1186/s40780-020-00180-w.
Generic drugs are heavily promoted in Japan. The aim of this retrospective single-center study was to clarify whether the frequency and reason that patients request a switch from a generic drug to the original drug differ according to therapeutic category and dosage form.
This study was performed at Chiba University Hospital. Prescription inquiries about 121 generic drugs from community pharmacies over a 3-year period (from July 2014 to June 2017) were analyzed.
Approximately 30% of the requests were related to the efficacy, safety, and comfort of the generic drug. The most cited motive was "patient's desire with no reason given" at 44.5%. According to multiple logistic regression analysis, therapeutic categories and dosage forms were associated with the requests. The median request frequency differed according to therapeutic category and dosage form. The frequency was highest for "agents affecting the central nervous system" and "tablets and capsules", respectively. Among the therapeutic categories, "agents affecting the central nervous system" had the highest median number of requests related to "decreased effectiveness"; "cardiovascular agents" had the highest median number of requests related to "physician's instruction"; and "agents for the epidermis" had the highest median number of requests related to "uncomfortable to use". Among dosage forms, the odds ratio for patients' original drug request for "liniment and patch" was about 1.5 times that for "tablets and capsules". "Liniment and patch" had the highest median frequency of requests related to "decreased effectiveness", "uncomfortable to use", and "patient's desire with no reason given".
The request frequency and reason differed according to therapeutic category and dosage form. Pharmacists should advise each patient properly about the choice and switching of drug brands, taking into account the therapeutic category and dosage form, especially liniments and patches.
仿制药在日本得到大力推广。这项回顾性单中心研究的目的是阐明患者要求从仿制药换成原研药的频率和原因是否因治疗类别和剂型而异。
本研究在千叶大学医院进行。分析了在3年期间（2014年7月至2017年6月）从社区药房获取的有关121种仿制药的处方查询情况。
约30%的请求与仿制药的疗效、安全性和舒适度有关。最常被提及的动机是“患者无理由的意愿”，占44.5%。根据多因素逻辑回归分析，治疗类别和剂型与这些请求相关。请求的中位数频率因治疗类别和剂型而异。“影响中枢神经系统的药物”和“片剂及胶囊剂”的频率分别最高。在治疗类别中，“影响中枢神经系统的药物”与“疗效降低”相关的请求中位数数量最高；“心血管药物”与“医生指示”相关的请求中位数数量最高；“表皮用药”与“使用不适”相关的请求中位数数量最高。在剂型方面，患者要求使用原研药的“搽剂和贴剂”的优势比约为“片剂和胶囊剂”的1.5倍。“搽剂和贴剂”与“疗效降低”、“使用不适”和“患者无理由的意愿”相关的请求中位数频率最高。
请求频率和原因因治疗类别和剂型而异。药剂师应根据治疗类别和剂型，特别是搽剂和贴剂，为每位患者提供关于药品品牌选择和换药的适当建议。
