Abstracts by key term: Generic substitution
The aim of the drug discount agreements in accordance with Section 130a Paragraph 8 of the Social Code V (SGB V) is to promote the exchange of drugs with the same active ingredients in accordance with Section 129 SGB V and thus reduce the drug costs of statutory health insurance companies. Due to the sharpening of discount agreements by the GKV-WSG on April 1, 2007, the topic of drug substitution has increasingly become the focus of interest and health policy discussions. However, replacing a medication with a discounted product is not always without risks. There are certain diseases or “critical indications” for which substitution is problematic due to the discount agreements agreed between drug manufacturers and statutory health insurance companies. This particularly affects patients with long-term drug therapy, such as: E.g. epilepsy patients or so-called “critical dose drugs” (active ingredients with a narrow therapeutic range). Exchanging drugs can have negative effects on the further course of the disease (seizure recurrences, toxicity), at least in well-controlled patients with epilepsy. The German Society for Neurology (DGN) therefore warns in its guidelines against an uncontrolled exchange of antiepileptic drugs in stable and well-controlled patients (DGN 2008).