Florida moves on five neg formulary drugs

Bills filed in the House and Senate of the US state of Florida wouldremove restrictions on five of the 11 drugs in the state's "negative formulary" for which generics cannot be substituted. Previous attempts to do this have failed but, with the sponsorship of House Majority Leader Mike Fasano and bipartisan support in the Senate, this looks more likely to succeed.

The bill would let doctors state on the prescription that patients should not be switched to a generic. Florida pharmacists now fill prescriptions with the cheapest version of a drug unless the patient or doctor requests a branded product but, for 11 drugs, no substitutions can be made. They include Coumadin (warfarin), made by Du Pont, which has strongly opposed previous attempts to change the law (Marketletters passim), Schering AG's Quinaglute (quinidine gluconate) and Parke-Davis' Dilantin (phenytoin). Generics of five of the drugs, including Coumadin, are approved by the Food and Drug Administration as "therapeutically equivalent."

Some doctors warn of potential mix-ups when drugs are switched and say that substitution in other states is not automatic but requires pharmacists to check with doctors. However, the bills' supporters forecast potential yearly savings of $40 million, and note no serious problems in the 48 other states that do not restrict generics.