Bioequivalence, Drugs with Narrow Therapeutic Index and The Phenomenon of Biocreep: A Critical Analysis of the System for Generic Substitution.

biocreep bioequivalence generics narrow therapeutic index drugs substitution

Journal

Healthcare (Basel, Switzerland)
ISSN: 2227-9032
Titre abrégé: Healthcare (Basel)
Pays: Switzerland
ID NLM: 101666525

Informations de publication

Date de publication:
26 Jul 2022
Historique:
received: 29 06 2022
revised: 22 07 2022
accepted: 23 07 2022
entrez: 27 7 2022
pubmed: 28 7 2022
medline: 28 7 2022
Statut: epublish

Résumé

The prescription of generic drugs represents one of the main cost-containment strategies of health systems, aimed at reducing pharmaceutical expenditure. In this context, most regulatory authorities encourage or obligate dispensing generic drugs because they are far less expensive than their brand-name alternatives. However, drug substitution can be critical in particular situations, such as the use of drugs with a narrow therapeutic index (NTI). Moreover, generics cannot automatically be considered bioequivalent with each other due to the biocreep phenomenon. In Italy, the regulatory authority has established the Transparency Lists which include the medications that will be automatically substituted for brand-name drugs, except in exceptional cases. This is a useful tool to guide prescribers and guarantee pharmaceutical sustainability, but it does not consider the biocreep phenomenon.

Identifiants

pubmed: 35893214
pii: healthcare10081392
doi: 10.3390/healthcare10081392
pmc: PMC9394341
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

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Auteurs

Lucia Gozzo (L)

Clinical Pharmacology Unit, Regional Pharmacovigilance Centre, University Hospital of Catania, 95125 Catania, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy.

Filippo Caraci (F)

Centre for Research and Consultancy in HTA and Drug Regulatory Affairs (CERD), University of Catania, 95125 Catania, Italy.
Department of Drug and Health Sciences, University of Catania, 95125 Catania, Italy.
Unit of Translational Neuropharmacology, Oasi Research Institute-IRCCS, 94018 Troina, Italy.

Filippo Drago (F)

Clinical Pharmacology Unit, Regional Pharmacovigilance Centre, University Hospital of Catania, 95125 Catania, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, 95125 Catania, Italy.
Centre for Research and Consultancy in HTA and Drug Regulatory Affairs (CERD), University of Catania, 95125 Catania, Italy.

Classifications MeSH