From today (February 1), when you receive a prescription in Australia, it will list the name of the medication’s active ingredient rather than the brand name. So, for example, instead of receiving a prescription for Ventolin, your script will say “salbutamol”.
This national legislation change, called active ingredient prescribing, is long overdue for Australian health care.
Using the name of the drug — instead of the brand name, of which there are often many — will simplify how we talk about and use medications.
This could have a range of benefits, including fewer medication errors by both doctors and patients.
What is an active ingredient?
The active ingredient describes the main chemical compound in the medicine that affects your body. It’s the ingredient that helps control your asthma or headache, for example.
Drugs are tested to ensure they contain exactly the same active ingredients regardless of which brand you buy.
There’s only one active ingredient name for each type of medical compound, although they may come in different strengths. Some types of medications may contain multiple active ingredients, such as Panadeine Forte, which contains both paracetamol and codeine.
There can be several brand names
Until now, doctors and other prescribers have used a mixture of brand and active ingredient names when prescribing medicines. An Australian study found doctors used brand names for 80.5% of prescriptions.
Different brands are available for most medications — up to 12 for some. Combined with active ingredient names, this equates to thousands of different names — too many for any patient, doctor, nurse or pharmacist to remember.
Here’s an example of the problem.
I ask John, a patient whom I’ve just met, whether he takes cholesterol medications, commonly called statins. The active ingredient names for this group of medications all end in “statin” (for example, pravastatin, simvastatin).
“Ummm, I’m not sure, is it a blue pill?” John asks.
“It could come in many colours. It might be called atorvastatin, or Lipitor,” I reply. “Perhaps rosuvastatin, or Crestor, or Zocor?”
“Ah yes, Crestor, I am taking that,” John exclaims, after deliberating for some time.
This is a common and important conversation, but could be simpler for both of us if John was familiar with the active ingredient name.
And while we did eventually come to the answer, this medication could have easily been overlooked, by both John and myself. This may have significant implications and interact with other medicines I might prescribe.
Cause for confusion
The main problem with using brand names for medications is the potential for confusion, as we see with John.
A prescription written using a brand name doesn’t mean you can’t buy other brands. And your pharmacist may offer to substitute the brand specified for an equivalent generic drug. So, people often leave the pharmacy with a medication name or package that bears no resemblance to the prescription.
When the terms we use to describe medicines in conversation, on prescriptions and what’s written on the medication packet can all be different, patients might not understand which medications they’re taking, or why.
This often leads to doubling up (taking two brands of the same medication), or forgetting to take a certain medication because the name on the package doesn’t match what’s written on your medication list or prescription.
Confusion resulting from using brand names has been associated with serious medication errors, including overdoses. Elderly people are the most susceptible, as they’re most likely to take multiple medications.
Even when the confusion doesn’t cause harm, it can be problematic in other ways. If patients don’t understand their medicines, they may be less likely to be proactive in making decisions with their doctor or pharmacist about their health care.
Health professionals can also get confused, potentially leading to prescribing errors.
What are the benefits of active ingredient prescribing?
The main benefit of the switch is to simplify the language around medications.
Once we become accustomed to using one standardised name for each medicine, it will be easier to talk about medicines, whether with a family member, pharmacist or doctor.
The better we understand the medications we’re using, the fewer errors we make, and the more control we can take over our medication use and decisions.
This change will also serve to promote choice.
When you’re prescribed a medicine with a certain name, you’re more likely to buy that brand. In some cases there may be generic medicines that are cheaper and just as effective. Or there may be other forms of the medication that better suit your needs, such as a capsule only available in another brand.
Not too much will change
This new rule is not expected to lead to extra work for doctors, pharmacists or other health professionals who prescribe medicines, as most clinical software will make the transition automatically.
Doctors can elect to still include the brand name on the prescription, if they feel it’s important for the patient. But aside from some limited exceptions, the active ingredient name will need to be listed, and will be listed first.
Some active ingredient names may be a bit longer and more complex than certain brand names, so there might be a period of adjustment for consumers.
But in the long term, this change will streamline terminology around medicines and make things easier, and hopefully safer, for everyone.
Next time you receive your prescription, have a look at the name of the active ingredient. Remember it, and use that name when you talk to your family, doctor and pharmacist.