Pharmacies are routinely ignoring doctors’ orders to give patients branded medicines in order to cut costs, according to a survey by the Dutch patients’ federation.

Doctors often specify that patients should receive a particular brand, adding the term ‘medically necessary’ to the prescription. Changing the manufacturer can lead to unwanted side-effects or reduce the effectiveness of the treatment.

In a survey of 2900 patients who had been prescribed a specific brand, pharmacists struggled to obtain the correct medicine in 28% of cases, the Patiëntenfederatie said. Pharmacists said they often had no choice but to supply an alternative because of budgetary restrictions set by insurers.

Federation spokeswoman Dianda Veldman criticised pharmacists for overruling doctors’ without consultation. ‘Often they don’t tell the patients at the counter, so that people don’t know they’re getting a different medicine until their body reacts.’

However, Aris Prins, of the pharmacists’ organisation KNMP, said doctors used the term ‘medically necessary’ too liberally and cheaper medicines were not necessarily of lesser quality.

‘Obviously some patients benefit from receiving a specific brand, but they are in the minority. Medically necessary is the most devalued term there is.’

Prins argued it was more cost-efficient for pharmacies to keep several different brands of a medicine in stock. ‘The preference policy is a matter of saving pennies in order to keep things affordable. That is one of the terms patients agree to when they take out an insurance policy.’