Pregled lista i preporuka za zamenljivost lekova u izabranim evropskim zemljama
Sažetak
Generička zamena uvedena je u zdravstvene sisteme mnogih zemalja kako bi se smanjili troškovi i obezbedio kontinuitet snabdevanja tržišta lekovima. U ovom radu predstavljene su zajedničke i specifične strategije za generičku zamenu u nekoliko evropskih zemalja, kao i u Republici Srbiji. Faktori koje treba uzeti u obzir prilikom procene zamenljivosti lekova mogu se odnositi na sam lek ili pojedinačnog pacijenta i njegove specifične potrebe. Poseban oprez je potreban kod lekova sa uskim terapijskom širinom, lekova sa nelinearnom farmakokinetikom, antiepileptika, lekova sa produženim oslobađanjem, lekova koji se primenjuju na specifičan način ili pomoću medicinskog sredstva. Takođe treba obratiti pažnju na faktore kao što su različit izgled lekova, ekscipijensi, pakovanje, indikacija, ali i stanje pacijenta, njegov uzrast, prateće bolesti, trudnoća, funkcija šaka, vid, sposobnost gutanja, odnos pacijenta prema alternativnim lekovima. Pri zameni dva generička leka, treba imati na umu mogućnost da oni nisu međusobno bioekvivalentni, budući da je biološka ekvivalentnost potvrđena između generičkog i referentnog (najćešče originalnog) leka, što predstavlja dodatni rizik po bezbednost pacijenata. Politika generičke zamene specifična je za svaku zemlju. Pojedine zemlje su formirale liste zamenljivih lekova i/ili detaljne smernice u vezi sa zamenljivošću kako bi pomogle zdravstvenim radnicima pri donošenju odluka o zameni lekova.
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