Korean Association of Internal Medicine protests drug substitution notification flaws

The Korean Association of Internal Medicine is calling for a reversal of the simplified post-notification system for alternative dispensing. The association argues that the current system, which requires doctors to manually check the Health Insurance Review and Assessment Service portal to see if a pharmacist has substituted a prescribed drug, creates significant risks to patient safety.

Medical professionals expressed concern that if a doctor is unaware of a drug substitution, they cannot respond effectively to adverse drug reactions or medical accidents. The association highlighted cases where medications with identical ingredients but different manufacturers and appearances were substituted without the prescribing physician being notified through direct channels like phone or fax.

To address these issues, the association is demanding a more robust two-way notification system that provides real-time alerts to doctors. They also proposed requiring explicit patient consent for substitutions and suggested implementing a system similar to the American ‘Dispense As Written’ (DAW) model, which allows doctors to specify when a particular brand must be used.