Therapeutic Substitution for Generic Drugs

Using generic instead of brand-name drugs can save individuals, insurers and employers significant money. However, a new study indicates that billions more could be saved through therapeutic substitution.

Generic drugs have the same active ingredients as prescription drugs, but cost significantly less. Therapeutic substitution differs from using generics. It is the practice of using the least expensive generic drugs with a different chemical makeup for the same disease.

A study published in the May JAMA Internal Medicine reported on research done between 2010 and 2012. It found $73 billion of unnecessary spending on drugs. Researchers concluded that figure could have been lower if generic drugs or therapeutic substitution were used.

Opponents say that although different classes of drugs often work the same, some are not as effective. Some substitutions could also have harmful interactions with other drugs.

Therapeutic substitution requires better communications between physicians and pharmacists and improvements to the medical records system. It might also require a law change. Although pharmacists can substitute generic drugs for brand-name drugs, they don’t have the authority to practice therapeutic substitution without physician approval.

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