Switching among equivalents in chronic cardiovascular therapies : 'real world' data from Italy

Poluzzi, Elisabetta and Veronese, Giacomo and Piccinni, Carlo and Raschi, Emanuel and Koci, Ariola and Pagano, Paola and Godman, Brian and Marchesini, Giulio and Boriani, Giuseppe and De Ponti, Fabrizio (2016) Switching among equivalents in chronic cardiovascular therapies : 'real world' data from Italy. Basic and Clinical Pharmacology and Toxicology, 118 (1). pp. 63-69. ISSN 1742-7835 (https://doi.org/10.1111/bcpt.12442)

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Abstract

Since August 2012, Italian general practitioners are required to prescribe the generic name of medicines, except for refill of chronic therapy. We evaluated the extent of switching among equivalents in chronic cardiovascular therapies, the influence of the 2012 regulatory intervention and of patient-related or drug-related factors. Prescription of off-patent antiarrhythmics, oral antidiabetics, and ACE-inhibitors dispensed from August 2011 to August 2013 within the Bologna Local Health Authority (870,000 inhabitants) were collected. The rate of actual switching among equivalents was evaluated monthly. The effect of the regulatory intervention was estimated by interrupted time series analysis. Adjusted odds ratios (aORs) of switching were calculated for: age, gender, number of different equivalents available for each drug, change in dispensing pharmacy between subsequent refills. The average monthly rates of switches were 9.6%, 16.3%, and 16.3% for antiarrhythmics, antidiabetics, and ACE-inhibitors, respectively. Values significantly increased soon after the regulatory intervention for ACE-inhibitors (+1.81%, p=0.00), antiarrhythmics (+1.46%, p=0.01) and antidiabetics (+1.09%, p=0.01), and no significant decreasing trends were observed in the following 12 months. For all drug classes, odd of switching was higher in case of change in dispensing pharmacy (up to aOR=4.31, 95CI=4.26-4.35 for ACE-inhibitors) and availability of ≥5 different equivalents (up to aOR=7.82, 95CI=7.39-8.28 for antidiabetics). Switching was lower for age ≥65 for antidiabetics and ACE-inhibitors (aOR=0.92, 95CI=0.90-0.93; 0.87, 0.86-0.88, respectively). The Italian regulatory intervention generated an immediate increase, not sustained in time, in switching among equivalents of cardiovascular therapies. Young age, high number of available equivalents and changes in dispensing pharmacy between subsequent refills were associated with switching.

  • Item type:Article
    ID code:53574
    Dates:
    Date
    Event
    1 January 2016
    Published
    2 August 2015
    Published Online
    29 June 2015
    Accepted
    Notes:This is the peer reviewed version of the following article: Poluzzi, E., Veronese, G., Piccinni, C., Raschi, E., Koci, A., Pagano, P., ... De Ponti, F. (2015). Switching among equivalents in chronic cardiovascular therapies: 'real world' data from Italy. Basic and Clinical Pharmacology and Toxicology . 10.1111/bcpt.12442, which has been published in final form at http://dx.doi.org/10.1111/bcpt.12442. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
    Subjects:Medicine > Pharmacy and materia medica
    Department:Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences
    Depositing user: Pure Administrator
    Date deposited:01 Jul 2015 15:30
    Last modified:11 Nov 2024 11:08
    Related URLs:
    URI:https://strathprints.strath.ac.uk/id/eprint/53574
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