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DN Debate. Patient safety is threatened when more and more drugs are back-ordered

it has become increasingly common with backordered medications. This means that medicines prescribed on the prescription is not available, usually without the p

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DN Debate. Patient safety is threatened when more and more drugs are back-ordered

it has become increasingly common with backordered medications. This means that medicines prescribed on the prescription is not available, usually without the patients or the prescribing doctor get the information if and when the drug in question again is available to download.

currently, there are 366 different preparations on the Sticky side of the restnoteringar. These include various antibiotics, blodtrycksläkemedel, antidepressants, and a variety of analgesic preparations, and also medicines in case of serious unusual diagnoses. This means that tens of thousands of people in Sweden no longer be able to collect the prescription medicine, with the risk of serious health effects as a result.

Restnoteringar has increased in the pharmaceutical distribution through pharmacies been commercialised. If there is a connection is unclear. Occasionally, information that a facility for the pharmaceutical manufacturing burned, that a drug is temporarily out of stock, or that the manufacturing process must be changed. But most often it is completely unclear what prompted the residual listing.

At the residual listing can alternative medicines be. A patient can then be prescribed sleeping pills in double dose, or treatment of stomach ulcers occur via three different recipes, then standardförskrivningen which includes three drugs in a prescription are gone noticed. Sometimes it can be a package left at a different pharmacy. We know of a patient who visited 20 pharmacies in Stockholm to find a remaining package (although this information should be available on the Fass.see). Another patient traveled to Uppsala to visit the pharmacies there in search of drugs. A third went from Stockholm to Hudiksvall where the pharmacy stated that the requested drug was.

another patient traveled to Uppsala to visit the pharmacies there in search of drugs. A third went from Stockholm to Hudiksvall where the pharmacy stated that the requested drug was.

the Situation can be solved if there are drugs approved abroad, and if they can be obtained via a licence application to the medical products agency. A licence application to the Mpa results in increased administration and increased costs when these drugs are not prisförhandlade. Waiting on the license to be approved, and that the drug sometimes must be imported delay the further active drug treatment.

Patients can have symptoms such as palpitations, sweating, weight loss and serious heart rhythm disorders. An approval may be at risk for the development of life-threatening symptoms. Fail the licence application will be notified not always the prescriber, which may further delay active treatment. Other patients who need medications before certain operations can not be scheduled for surgical intervention before the drug has been obtained.

a year ago, was the most common drug to men with testosterone deficiency gone noticed. It meant many contacts to get prescription of alternative medications and information on how this would be administered. All this leads to ill-health and insecurity. The risk that the drugs hamstras or patients to buy medicines on the web also increases. The latter would also increase the risk of the drugs not containing it are marketed or are contaminated with prohibited substances, viruses or bacteria.

another option is to prescribe medications ex tempore, which means that a request is sent to a company to tailor a drug. Although this involves extra administration, insecurity, waiting times and, not least, high costs.

What do the relevant authorities to resolve this situation? The political will is to optimize the secure drug sales and distribution?

A company that gets a drug approved in Sweden also has a requirement that it should be accessible. Our impression is that, when the specified residual listing fall this requirements away. Pharmaceutical companies have the responsibility to notify the restnoteringar to the Fda, but us health care providers, and for patients to receive their drugs, they have no responsibility when they announced their restnoteringar.

This is a trust, our patients should be able to trust that the medicines work well and are safe, and that they can be delivered in a reasonable time. Unfortunately, that is not the pharmaceutical industry (LIF) a partsorgan for pharmaceutical companies on this issue, then they represent the pharmaceutical companies that conducts research. Each individual company has in place the responsibility.

the national Board of health and the Swedish association of local authorities and regions (SALAR) is the dumb, as well as the responsible minister with responsibility for these issues.

the Swedish medical products agency indicates on its website (addressed to the doctor): ”When you prescribe a drug, it may be a good idea to first check that the medicines you choose to prescribe is not gone noticed via the medical products Agency's list of restnoteringar”. The fda furthermore states: ”if you Have further questions or want more information about the backorder drugs you can turn to the company responsible”. We try with these ways, which is not easy to catch, and that is not facilitated by the fact that the Mpa restnoteringslista is not up to date.

If the current rules are for the weak need the law to be tightened and the requirements set by the relevant authority.

On the supervisory authorities, primarily the medical products agency, not paid attention to the this should their mission be clarified.

On the issue of liability is unclear between the Mpa, SKL and the national Board of health to monitor and bring about improvements, have the responsibility to be clarified.

On the Swedish medical products agency need resurstillskott to solve this need the power of the state to allocate these.

strong action where division of responsibility is clarified between the company and the authority is necessary to ensure that the drug therapy can be done without unnecessary delay. Otherwise, increase the risks of irreversible health effects and reduced quality of life.

When apoteket's monopoly ended in 2009 were also the statutory obligation that the state pharmacy had had, to be responsible for the country's drug supplies. Apoteket's mission to the defense bill have the resources to be able to ”strengthen society's ability to prevent and manage severe stresses and strains in the society”.

Now we have frequent restnoteringar but without legal obligation. It was probably not what was intended by the reform. The ministry of health should now begin work to review current legislation, initiate improvements in the medical products and strengthening the requirements on pharmaceutical companies to ensure that medicines are available.

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