Drug substitution ethics
April 5, 2012
PHARMACISTS who are
dispensing a “pharmacy preferred
brand” of generic drugs without
consulting with their patient are
contravening the Pharmaceutical
Society of Australia’s (PSA)
Guidelines on Brand Substitution,
according to the PSA.
The comments come in response
to increasing reports of “pharmacy
preferred” dispensing without
consultation, which National
President of the PSA, Grant
Kardachi, condemned, saying that
all dispensing of generic medicines,
including preferred brands, must
comply with the PSA guidelines.
“These guidelines were set up to
protect the best interests of consumers
when non-brand medicines are
dispensed,” said Kardachi.
The guidelines, according to
Kardachi, have two important
elements which relate to dispensing
pharmacy preferred brands, the
first of which states that “brand
substitution may only occur after
consultation with and agreement of
the patient and if the prescriber has
not indicated on the prescription,
‘no substitution or equivalent’”.
“This means that pharmacists
cannot just dispense a generic or
‘pharmacy-preferred brand’
without discussion with the
consumer,” Kardachi said.
“And that discussion on possibly
dispensing a non-brand medicine
can only begin if the doctor has not
indicated otherwise on the
prescription,” he added.
The second relevant element in
the guide relating to preferred
substitution states that “where
substitution is allowed and the
patient is offered or enquires about
alternate brands, the pharmacist
and the patient should discuss the
safety and suitability of alternate
brands for that patient.”
“Quite clearly the role of the
pharmacist is to help the patient
and to ensure the best outcomes
for the patient,” Kardachi said.
“The pharmacist is there to help the
patient, guide them, and clear up any
confusion or issue they may have.
“They are committed to ensuring
the best possible health outcomes
for the patient,” he added.
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