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Israel introduces generic drugs scheme

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7210.592 (Published 04 September 1999) Cite this as: BMJ 1999;319:592
  1. Judy Siegel-Itzkovich
  1. Jersusalem

    Israeli pharmacists may now substitute cheaper generic versions of prescription drugs for brand name drugs if the prescribing doctor does not use the commercial name.

    In addition, those working in both private and health fund pharmacies have been permitted to advise customers on over the counter drugs and suggest what is most suited to them.

    These changes came into effect recently with amendments to the Pharmacists' Order passed earlier this year by the Knesset (parliament). The amendments were initiated by the health ministry director general, Professor Yehoshua Shemer.

    If the doctor does not give the commercial name of the drug, the pharmacist may substitute a generic medication, but only if the substitute has the same active ingredients, form, and medical effect as the original. This is expected to reduce the costs to the four public health funds and the health system in general, said Professor Shemer, but he did not have figures on how much would be saved.

    Pharmaceutical companies did not lobby against the amendments, as the major companies produce generic as well as branded drugs. “We were neutral on this,” said a senior official of one of Israel's largest drug firms.

    The new rules could help to promote parallel imports of pharmaceuticals from Europe and other countries, to break the monopolies of pharmaceutical importers with monopoly rights to a certain drug.

    The changes expand the authority of licensed pharmacists but also put more responsibility on their shoulders; they can be sued if their advice is faulty and they harm patients.

    Howard Reiss, chairman of the Israel Pharmacists Association, commented that his organisation had for years been demanding more responsibility for pharmacists, “who are the greatest wasted resource in the country.” He maintained that 5-8% of all patients in hospital are there because of taking drugs that interfere with one another or are contraindicated by their condition and said that each year between 2000 and 2500 Israelis die because of these drug complications.

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