Safe and appropriate use of generic medicines A kit for training community pharmacy assistants

1. Safe and appropriate use of generic medicinesA kit for training community pharmacy assistants

2. Safe and appropriate use of generic medicinesA kit for training community pharmacy assistants This PowerPoint presentation and accompanying article have been developed by the National Prescribing Service Limited in collaboration with the Pharmaceutical Society of Australia and the Pharmacy Guild of Australia. This information was previously published by the Pharmaceutical Society of Australia, as part of its Pharmacy Self Care program, in December 2007. The information was included in a special edition of inPHARMation and an accompanying pharmacy training storyboard, Communicating with consumers.

3. Learning objectives In relation to generic medicines • Understand it’s the consumer’s choice • Be able to respond to common questions from consumers • Be able to assist pharmacists with receiving prescriptions and handing out medicines to consumers In relation to brand switching • Appreciate when it may be inappropriate • Be familiar with the pharmacy’s policy • Be aware of strategies that minimise consumer confusion

4. Generic medicines • Same active ingredient as the original brand of medicine • Made by the company who made the original brand, or made by a different company • Meet the same high Australian standards as the original brand • May differ from the original brand in colour, shape, size and/or taste • May be less expensive than the original brand

5. Generic medicines and brand switching Only generic brands which are proven to be bioequivalent are interchangeable with the original brand

6. Benefits of using generic medicines • Consumers – potential cost savings • Community – improves the value for money spent on health care • Pharmacies – better stock and financial management as managers can rationalise the number of brands stocked

7. Brand switching is the consumer’s choice • Brand switching cannot occur without the consumer’s consent • Be mindful of why some consumers may choose not to switch brands • Pharmacists and pharmacy assistants can help consumers by providing information

8. When is brand switching not appropriate? • Generic brand is not bioequivalent to the original brand • Prescriber has indicated brand switching is not allowed • Medicines with a narrow margin between effective and toxic doses • Consumers with an allergy to one of the non-medicinal components • Consumers who may be easily confused

9. Pharmacy brand switching policy Pharmacies must have a brand switching policy that covers • When and how brand switching is offered • Obtaining consumers’ consent • Recording consumers’ preferences for brand switching • Offering consistent brands • Minimising the impact of switching on consumers on long-term therapy • Responding to brand switching requests contrary to prescribers’ wishes

10. Medicine confusion and misadventures Some consumers may become confused about their medicines because • The same medicine has different brand names and appearances • They are not aware of medication changes • They are discharged from hospital with a different brand of the same medication Strategies to avoid confusion • Supply the same brand consistently • Use the reminder label “This medicine replaces ..... Do not use both” • Emphasise the active ingredient name • Include the reason for using the medicine • Offer a Medicines List • Offer dose administration aid • Encourage use of the same pharmacy

11. Frequently asked questions • What are generic medicines? • What is the difference? • Are they the same? • Will they be just as effective? • Why are they cheaper? • How much money will I save?

12. Prescriptions that allow brand switching Is the ‘brand substitution not permitted’ box on the prescription ticked? NO Has the consumer had the medicine before? YES NO Are they happy with the brand they were dispensed last time? Would they prefer a generic brand? YES NO YES NO Pharmacist to dispense the brand dispensed last time Is there a preferred brand? Pharmacist to dispense generic brand OR if unavailable or inappropriate, pharmacist to explain to consumer Pharmacist to dispense brand stated on the prescription YES NO Pharmacist to dispense preferred brand OR if unavailable or inappropriate, pharmacist to explain to consumer Pharmacist to dispense another brand OR if unavailable or inappropriate, pharmacist to explain to consumer

13. Prescriptions that don’t allow brand switching Is the ‘brand substitution not permitted’ box on the prescription ticked? YES Did the consumer request a generic brand of medicine? YES NO Pharmacist to explain situation/contact prescriber Don’t offer a generic brand Pharmacist to dispense as per prescription

14. Supplying dispensed medicines to consumers New prescriptions • Pharmacist should counsel consumers and provide a Consumer Medicine Information leaflet Repeat prescriptions • Show the medicine and check if the consumer is familiar with the brand supplied • Ensure the consumer can find the name of the active ingredient on the medicine package • If applicable, check that the consumer is aware of the product that it replaces • Ask if the consumer has a Medicines List and request the pharmacist to update the list if required