PERSPECTIVE
Prescription switching: Rationales and risks
Michael G. Kirby,
Paula Allchorne,
Tim Appanna, Patrick Davey, Richard Gledhill, James S. A. Green,
Damian Greene, Derek J. Rosario,
Corresponding Author
Michael G. Kirby
The Prostate Centre, London, UK
Correspondence
Michael G. Kirby, 30 Wedon Way, Bygrave, Baldock, Herts SG7 5DX.
Email: [email protected]
Search for more papers by this authorPaula Allchorne
Barts Health NHS Trust, The Royal London Hospital, London, UK
Search for more papers by this authorJames S. A. Green
Barts Health NHS Trust, The Royal London Hospital, London, UK
Search for more papers by this authorMichael G. Kirby,
Paula Allchorne,
Tim Appanna, Patrick Davey, Richard Gledhill, James S. A. Green,
Damian Greene, Derek J. Rosario,
Corresponding Author
Michael G. Kirby
The Prostate Centre, London, UK
Correspondence
Michael G. Kirby, 30 Wedon Way, Bygrave, Baldock, Herts SG7 5DX.
Email: [email protected]
Search for more papers by this authorPaula Allchorne
Barts Health NHS Trust, The Royal London Hospital, London, UK
Search for more papers by this authorJames S. A. Green
Barts Health NHS Trust, The Royal London Hospital, London, UK
Search for more papers by this authorSummary
Background
Therapeutic drug switching is commonplace across a broad range of indications and, within a drug class, is often facilitated by the availability of multiple drugs considered equivalent. Such treatment changes are often considered to improve outcomes via better efficacy or fewer side effects, or to be more cost-effective. Drug switching can be both appropriate and beneficial for several reasons; however, switching can also be associated with negative consequences.
Aim
To consider the impact of switching in two situations: the use of statins as a well-studied example of within-class drug switching, and gonadotropin-releasing hormone (GnRH)-targeting drug switching as an example of cross-class switching.
Results
With the example of statins, within-class switching may be justified to reduce side effects, although the decision to switch is often also driven by the lower cost of generic formulations. With the example of GnRH agonists/antagonists, switching often occurs without the realisation that these drugs belong to different classes, with potential clinical implications.
Conclusion
Lessons emerging from these examples will help inform healthcare practitioners who may be considering switching drug prescriptions.
DISCLOSURES
RG has received honoraria from Astellas Pharma. DJR has attended advisory groups for Ferring, received an unrestricted educational grant from Bayer and is a holder of programme grants from NIHR. MK, PA, TA, PD, JG and DG declare no conflict of interest.
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