Therapeutic interchange is the act of switching a prescribed drug for another drug in the same therapeutic class that is believed to be therapeutically similar but may be chemically different.
What does therapeutic interchange mean in pharmacy?
MEDICAL STAFF–APPROVED THERAPEUTIC INTERCHANGES Therapeutic Interchange is the practice of dispensing a therapeutically equivalent medication in place of the medication ordered. Only therapeutic interchanges approved by the medical executive committee are allowed.
What is therapeutic substitution and drug switching?
Therapeutic substitution, known also as drug switching and therapeutic interchange, is the practice of replacing a patient’s prescription drugs with chemically different drugs that are expected to have the same clinical effect. Many times patients switch to a different drug with no problems.
What is the difference between a therapeutic exchange and formulary?
The use of therapeutic interchanges relies on a pre-approved protocol for hospitals, institutional settings, health plans, pharmacy networks, and managed care plans. A formulary is a list of approved medications that can be prescribed by physicians.
How are interchanges made with formulary medications?
Therapeutic interchange with the formulary medication is made as indicated in the dose/frequency column. If the dose/frequency column is blank, interchanges are made at the same dose and interval as the original order. If only a dose is noted in the dose/frequency column, interchanges are made at the same frequency as the original order.
What medications are considered therapeutic substitutions?
Some examples of antidepressants: Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram), and Lexapro (escitalopram).
What does therapeutically equivalent mean?
Approved drug products are considered to be therapeutic equivalents if they are pharmaceutical equivalents for which bioequivalence has been demonstrated, and they can be expected to have the same clinical effect and safety profile when administered to patients under the conditions specified in the labeling.
What does duplicate therapy mean?
Therapeutic duplication occurs when practitioners order more than one medication for the same indication.
What is formulary substitution?
Therapeutic substitution originates in an institution's formulary system. Arising from the need for rational drug therapy within the context of increasing medical care costs, the formulary system is devised and ap- proved by an institution's medicai staff for the objective evaluation, selection, and use of drugs.
What is the difference between pharmaceutical equivalent and therapeutic equivalent?
Therapeutic Equivalents: Drug products are considered to be therapeutic equivalents only if they are pharmaceutical equivalents and if they can be expected to have the same clinical effect and safety profile when administered to patients under the conditions specified in the labeling.
How can you find out if two drugs are therapeutic equivalents?
Two drug products are deemed to be pharmaceutical equivalents if they have the same active ingredient(s), strength or concentration, dosage form, and route of administration.
Which is an example of therapeutic duplication?
For example, prescribing both ibuprofen and acetaminophen for PRN mild pain, or prescribing both Zofran and Compazine for PRN nausea and vomiting.
What happens when there is therapeutic duplication?
Therapeutic duplication increases the likelihood that a patient can experience adverse effects due to increased ingredient concentrations in the body, as well as drug-drug interactions. This is potentially harmful to the patient and should be avoided.
Which of the following is an example therapeutic duplication?
Therapeutic duplication is the practice of prescribing multiple medications for the same indication without a clear distinction of when one agent should be administered over another – for example, pain, nausea and vomiting, and constipation.
What are the benefits of a therapeutic interchange?
Therapeutic interchange programs enable pharmacy managers to neutralize or at least slow the rate of drug cost increases, ensuring appropriate utilization of resources and more favorable patient outcomes.
What does substituted for mean on a pill bottle?
Generic substitution means a brand name drug is switched to a generic with the same active ingredients and is approved by the United States Food and Drug Administration (FDA) as an equivalent drug. 1, 2 This is typically done to save money for an insurer.
What is the meaning of therapeutic equivalence quizlet?
- Therapeutic equivalence occurs when two drugs are bioequivalent, have the same active ingredient, and have the same strength, dosage form, and route of administration. - A brand name drug and its generic counterpart with the same dosage form, strength, and route of administration are therapeutic equivalents.
What does generic equivalent mean?
Generic Equivalent or "generically equivalent" means a drug that has an identical amount of the same active chemical ingredients in the same dosage form, that meets applicable standards of strength, quality and purity according to the United States pharmacopeia or other nationally recognized compendium and that, if ...
What is the therapeutic range of a drug?
The therapeutic range of a drug is the dosage range or blood plasma or serum concentration usually expected to achieve the desired therapeutic effect. This does not mean that patients may not achieve benefit at concentrations below the minimum threshold, or may not experience adverse effects if kept within the range.
What is the difference between pharmaceutical and therapeutic?
pharmacological effects belong to drugs effect on body and therapetic effects is how drug work positively. pharmacologiacal effect means both study of pharmacokinetics and pharmacodynamics of the drug.
Why Are Therapeutic Interchange Programs Used?
Therapeutic interchange programs are commonly used by hospitals to improve patient outcomes, decrease side effects, and decrease medication and treatment costs for both the patient and medical organization. For example, medications that are therapeutically interchanged are chosen because they have the same or improved clinical outcomes as the originally chosen medication. They may also be more convenient for the patient by decreasing how often a medication has to be taken in order to be effective.
Why do pharmacies use therapeutic interchange?
Therapeutic interchange programs are commonly used and help pharmacies keep an organized formulary. There is no way a pharmacy can keep every medication available for patients. By choosing approved medications that can be interchanged with other medications in the same drug class, they can save money and maintain an adequate supply of the medication.
What is therapeutic substitution?
Therapeutic substitution, known also as drug switching and therapeutic interchange, is the practice of replacing a patient’s prescription drugs with chemically different drugs that are expected to have the same clinical effect. Many times patients switch to a different drug with no problems. However, for certain medications ...
Which association opposes therapeutic substitution?
The American Heart Association and the American College of Cardiology oppose therapeutic substitution and believe that only the prescribing doctor is equipped to determine the best drug or combination of drugs.
What is the drug group for antidepressants?
Antidepressants are associated with drug groups known as MAOIs, tricyclics, and SSRIs and are commonly prescribed by psychiatrists and other physicians to treat depression, bipolar disorder, and other mental illness. Substitution concerns:
Is it important to talk to your doctor about substitution?
As with any substitution, it is important to talk to your doctor, and be aware of the benefits and risks of substitution.
Can you change medication from one medication to another?
The Epilepsy Foundation says that changing from one drug formulation to another can usually be done successfully if the patient’s blood levels , seizures, and toxicity are carefully monitored, but it says any medication change must require the permission of the treating doctor and the patient. Proton-pump Inhibitors.
Can you switch to a different drug?
Many times patients switch to a different drug with no problems. However, for certain medications and conditions, therapeutic substitution could cause problems. Consumers with a few specific conditions may be more likely than others to encounter a switch. Here are some of the conditions in which therapeutic substitutions may be more common, ...
What is therapeutic interchange?
Therapeutic interchange is the act of switching a prescribed drug for another drug in the same therapeutic class that is believed to be therapeutically similar but may be chemically different. Therapeutic interchange is different from generic substitution in that it does not occur between therapeutically equivalent products; instead, products are substituted for those that are likely to have a substantially equivalent therapeutic effect generally at a lower cost. Therapeutic interchange is common in institutional settings across the United States but rarely occurs in community pharmacy settings without a pharmacist first contacting the original prescriber and requesting a new prescription in order to facilitate a change.
How does therapeutic interchange work in pharmacy?
8 - 10 Community pharmacies do not have closed formularies nor formulary committees to leverage for therapeutic interchange. Prescribers may, however, be able to authorize therapeutic interchange on a patient-by-patient basis in community pharmacy settings by allowing pharmacists to leverage the formulary of the patient’s health plan. This approach can replicate the safeguards established within an institutional setting while saving money and reducing bureaucratic hassles. To date, 3 states have adopted this practice into law. The purpose of this article is to explore the legislative and regulatory considerations in authorizing therapeutic interchange in community pharmacy settings.
What states allow therapeutic interchange?
As of 2018, Arkansas, Idaho, and Kentucky have passed laws to enable therapeutic interchange in community pharmacy settings. In general, these laws require the original prescriber to opt-in to allow therapeutic interchange, and the pharmacist generally must leverage the formulary of the patient’s health plan to guide decision making within the same therapeutic class. These 3 states require that the pharmacist notify the original prescriber of any interchange in order to ensure a complete and accurate medication record. When appropriately structured, state laws enabling therapeutic interchange in community pharmacy settings allow pharmacists to use their medication expertise to save valuable time and enhance patient care while reducing health care costs.
How much does therapeutic interchange save?
3 A second study found that therapeutic interchange saved a managed care organization a mean of $20.31 per prescription filled and saved patients a mean of $14.76 per prescription filled. 4 Johansen and Richardson (2016) estimated potential savings of therapeutic interchange and projected savings of $73 billion in excess branded drug overuse. 5
Which states require substitution of a drug?
Idaho and Kentucky require that the substitution be in compliance with the patient’s health plan formulary, such as changing from a nonpreferred drug to a preferred drug. Arkansas states that the substitution must be to a drug “that is at a lower cost to the patient.” Idaho adapts this lower cost language for patients who do not have health plan coverage, allowing switches to a lower-cost drug in these instances. Kentucky is silent on how to handle interchange for patients without an insurer.
Can narrow therapeutic index drugs be interchanged?
Policy can expressly prohibit interchange for narrow therapeutic index drugs. Idaho law states: “Nothing in this section shall apply to…narrow therapeutic index drugs.” Idaho law further defined narrow therapeutic index drugs as “a drug where a small difference in dose or blood concentration may lead to serious therapeutic failures or adverse drug reactions.”
Which states have the same therapeutic class?
Arkansas followed suit in 2015, and Idaho’s legislation took effect on July 1, 2018. Arkansas and Idaho have adopted an identical definition of “therapeutic class” to guide interchange: “A group of similar drug products that have the same or similar mechanisms of action and are used to treat a specific condition.”
