Patient's Medication Choice of Brand

Pharmacist regulations changed this year.  Pharmacists are now permitted to dispense bio-equivalent formulas of medications to patients on a generic basis when the 'Brand Substitution Box" has not been ticked on a prescription.  The ATF continue to receive complaints from patients who have been given a different brand that what they usually take and have been prescribed.

It is now becoming a serious problem, as pharmacists quite often:

• Change brands/formulas, without consulting first with patients
• Patients can be told their original brand has been discontinued
• Patients can be told their thyroid medication no longer needs refrigeration when given a different brand/formula to the one they usually take
• Patients are not told that while certain brands/formulas are listed as being biologically equivalent that does not mean they are interchangeable in any given patient.

Patients are often confronted and in some cases bullied into taking a brand the pharmacist has chosen to stock, instead of the patient's original brand and the one that works for them.

They are not all the same, even though they may be listed on the Pharmaceutical Benefits List as being biologically equivalent!

The active ingredient of brands/formulas can vary from one brand to another, as can the excipients and therefore they are not all the same, which pharmacists should know.

Patients have a choice of brand, which their treating doctor has prescribed based on their medical history, diagnosis and performance of a particular brand/formula. This must continue to be respected by pharmacists to ensure patients continue to benefit, feel well and their thyroid health is not compromised. Thyroid conditions vary from thyroid cancer, to thyroidautoimmune disease, pregnancy and thyroid and more. Doctors base their prescribed brand/formula on a patient's diagnosed condition, blood results and the best brand/formula they believe will benefit the patient and carefully adjust the dosage of that particular brand of Levothyroxine until they achieve an optimal result with an individual patient.

The ATF recommends patients should continue on their original brand. A brand/formula should only be changed after a patient has consulted their treating doctor and if the doctor believes it is necessary, not changed on a pharmacist discretion.  New brand/formulas should only be dispensed to patients who are newly diagnosed or when the treating doctor believes there is a medical reason to change to another brand of medication.

Pharmacists are not thyroid specialists, do not know the patient's medical history or diagnosed thyroid disorder and therefore should do what they are there for, to dispense a prescribed medication.