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Adopted by the 42nd World Medical Assembly Rancho
Mirage, CA., USA, October 1990
and rescinded at
the WMA General Assembly, Santiago 2005
| WHEREAS: |
Therapeutic Substitution is one
form of drug substitution. Therapeutic substitution occurs
when a pharmacist substitutes a chemically different drug
for the drug that the physician actually prescribed. The drug
substituted by the pharmacist belongs to the same pharmacologic
class and or to the same therapeutic class. However since
the two drugs have different chemical structures, potentially
adverse outcomes for the patient can occur. |
| WHEREAS: |
Genetic substitution is entirely
different from therapeutic substitution. In generic substitution,
a generic drug is substituted for a brand name drug. However,
both drugs have the same active chemical ingredient, same
dosage strength, and same dosage form. |
| WHEREAS: |
The prescription of a drug represents
the culmination of a careful deliberative process between
physician and patient aimed at the prevention, amelioration
or cure of a disease or problem. This deliberative process
requires that the physician evaluate a variety of scientific
and psychological data including costs and make an individualized
choice of therapy for the patient. |
| WHEREAS: |
Physicians have the responsibility
for diagnosing the patient's condition and for the development
of a treatment plan, including the prescribing of appropriate
drugs and medications.
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BE IT RESOLVED that the World Medical Association supports:
- Individualization of therapy for patients based on
a complete clinical database compiled from a comprehensive
history, current physical findings, all relevant laboratory
data, and psychosocial factors.
- Maintaining the prescription authority of the physician
so that the patient will receive organized, effective
care.
- Requiring the pharmacist to dispense the exact chemical,
dose, and dosage form prescribed by the physician.
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BE IT FURTHER RESOLVED that the World Medical Association
opposes:
- The concept of therapeutic substitution because it
results in prescribing based on incomplete information
and, thus may be harmful to patient welfare.
- Any governmental law or regulation that permits therapeutic
substitution.
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