The Virginia Society of Health-system Pharmacists supports the use of therapeutic interchange of various drug products by pharmacists where pharmacists and prescribers interrelate on the behalf of patient care as part of a comprehensive approach to quality, cost-effective patient care.

Background:

Therapeutic interchange is the process of replacing, with the prescriber's approval, a prescription drug originally prescribed for a patient with a prescription drug that is its therapeutic equivalent. Two or more drugs are considered therapeutically equivalent is they can be expected to produce identical clinical effectiveness and desired outcomes. Therapeutic interchange may also occur pursuant to agreements between pharmacists and prescribers under arrangements between pharmacists and prescribers who have previously established and agreed on conditions of interchange.

Therapeutic interchange should not be confused with generic substitution. Generic substitution is the replacement of drug products that contain the same active ingredients and are chemically identical in strength, concentration, dosage form and route of administration to the drug product prescribed. These products can also be termed "generic equivalents".

Therapeutic interchange programs are commonly used in health-care systems that provide comprehensive health care such as hospitals, managed health care plans and retail pharmacy networks. The heath-systems often have formularies, or the systems to identify preferred agents and may be a guide for physicians in cases where alternative drug products are available to treat particular patients' medical condition. These programs are guided by clinically based prescribing guidelines and are developed by a collaboration between physicians, pharmacists and other medical practitioners who are experts in the diagnosis and treatment of disease. Therapeutic interchange programs provide patients with medications to optimize patient care with the authorization of the patient's prescriber.

Approved by Board of Directors: 09/24/99

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