[e-drug] Re: Use of generic or brand names in prescriptions (7)

["Zhining Goh" <zhining.goh@gmail.com>]

In Singapore legislation does not make it compulsory for doctors to prescribe using only generic names. Pharmacists are required to dispense in
accordance to what the doctor writes. If a doctor prescribes Zocor 10mg, we
are required to dispense the branded product. If Simvastatin 10mg is
written, then it doesn't matter if we dispense the branded or generic
product.

However in the public hospitals and government polyclinics there is mutual
agreement that branded products can be automatically substituted by generics
unless otherwise specified. Public hospitals and polyclinics bear 80% and
20% of the patient load in secondary-tertiary and primary healthcare
respectively. In the community setting it is up to the pharmacist to take
the initiative to intervene with the doctor if a branded product is
prescribed - but it is likely that they do not stock generic products.
Interventions may also be done after discussion with patients and upon their
requests.

One issue that arises from the use of generics in the hospitals is that
different generic manufacturers may make a certain product (e.g. Atenolol
50mg) in different shapes and sizes and colors. For illiterate and geriatric
patients who depend on visual recognition to remember instructions
and indications, it may cause much confusion as they may get something that
looks different each time they fill a prescription. Hence it's important
that pharmacists and dispensing technicians emphasize this at the point of
dispensing. Reconciliation services are also offered.


Zhining Goh

Locum Pharmacist
Alexandra Hospital, Singapore
E-mail: <zhining.goh@gmail.com>

Immediate-Past Chairperson of Education and Practice
International Pharmaceutical Students' Federation (IPSF)