Is there a need for a formulary of clinically interchangeable medicines to guide generic substitution in Saudi Arabia?

The escalating healthcare expenditure is a major challenge to sustainability of the healthcare systems. To confront the escalating health expenditure in general and medicines expenditure in particular, many countries promoted the use of generic medicines. To promote generic medicines, many countries have adopted a generic substitution (GS) policy and generic prescribing. To effectively implement the GS policy, it is evident in the literature that it is essential to have an evidence-based guide on therapeutic equivalence and formulary of interchangeable medicines to guide responsible GS. In Saudi Arabia, GS is permissive and pharmacists are given the right to perform GS. While the prescriber's approval is not a requirement, patient consent is required when performing GS. Although there are some general drug references, such as the Saudi National Formulary (SNF) and list of registered medicines in the Saudi market, but there is currently no information available to healthcare professionals that documents the therapeutic and bioequivalence between medicines. Thus, it is essential to have a formulary of interchangeable medicines to guide appropriate GS or at least to include such vital information regarding therapeutic equivalence and brand interchangeability as part of the SNF. That, in turn, will not only make healthcare professionals more confident when providing GS, but will also enable the avoidance of situations where GS is inappropriate.Scopu

General practitioners’ knowledge, attitude and prescribing of antibiotics for upper respiratory tract infections in Selangor, Malaysia : findings and implications

Background: Antibiotics are widely prescribed especially for URTIs. Their irrational use can increase costs and resistance. Aim: Assess knowledge, attitude and prescribing of antibiotics for URTIs in, Selangor, Malaysia using a cross-sectional survey among GPs working in private clinics in 2011. Results: 139 physicians completed the questionnaire (response rate = 34.8%). 49.6% (n=69) agreed antibiotics are helpful in treating URTIs, with most GPs agreeing antibiotics may reduce URTI duration and complications. The majority of GPs reported they felt patients expected antibiotics, with 36.7% (n=51) agreeing patients would change doctors if they did not prescribe antibiotics and 21.6% (n=30) agreeing when requested they prescribe antibiotics even if they believe them unnecessary. When assessed against six criteria, most GPs had a moderate level of knowledge of prescribing for URTIs. However, antibiotic prescriptions could be appreciably reduced. Conclusion: Further programmes are needed to educate GPs and patients about antibiotics building on current initiatives