Francetić I, Lasagna L, Weintraub M, Karch F E
Ann Intern Med. 1980 Mar;92(3):419-23. doi: 10.7326/0003-4819-92-3-419.
We evaluated the New York State generic substitution law. This law mandates substitution of a less expensive product if the physician signs the prescription for an eligible brand name drug on the line marked "subsitution permissible." We purchased drugs by brand name and generically before the law went into effect. Later, we purchased the same drugs in the same stores using the formats "brand-dispense-as-written," "brand-substitution-permissible," and "generic." Mean savings from generic prescribing or substitution increased from 12.1% +/- 20.4% before the law to 26.2% +/- 10.5% (brand-substitution-permissible) and 27.2% +/- 14.2% (generic). Prices for the same drug written the same way varied enormously among pharmacies. Brand-dispense-as-written, brand-subsitution-permissible, and generic prices in the same store varied substantially and unpredictably. Savings were not passed on to consumers in 29% of postlaw comparisons. Assuring maximal savings requires extensive comparison shopping.
我们评估了纽约州的通用名药物替代法。该法律规定，如果医生在标有“允许替代”的线上为符合条件的品牌药开具处方，则必须替换为较便宜的产品。在该法律生效之前，我们按品牌名和通用名购买药品。之后，我们在同一家商店使用“按处方配发品牌药”“允许替代品牌药”和“通用名药”的形式购买相同的药品。通用名药处方或替代带来的平均节省从法律生效前的12.1%±20.4%增至26.2%±10.5%（允许替代品牌药）和27.2%±14.2%（通用名药）。以相同方式开具的同一种药物的价格在不同药店之间差异极大。同一家商店中按处方配发品牌药、允许替代品牌药和通用名药的价格差异很大且不可预测。在法律生效后的29%的比较中，节省的费用并未转给消费者。要确保最大程度的节省，需要广泛地比较选购。
