Robert Popovian, Pharm.D., MS., who is the senior director of U.S. Government Relations at Pfizer, just wrote about something that you probably don't know, and at the same time it's also pretty scary. And it is also a terrible idea, designed to save money on prescription drugs while undoubtedly harming patients. In his latest op-ed entitled "No Substitute for Better Study to Protect Patients," Popovian, who is as dead-on knowledgeable about the pharmaceutical universe as anyone you'll meet, raises a real concern: A proposed change that would allow pharmacy benefit providers to substitute a different drug from the one on the prescription. And, this is not simply using a less expensive generic version of a drug, but rather, it is using a different drug in the same class. This is wrong on so many levels. "Therapeutic substitution should not be confused with generic substitution," Dr. Popovian explains. "Unlike therapeutic substitutions, generic substitutions involve drugs with the same active ingredients as determined by the FDA (or the equivalent government agency) as well as strength and dosage form that are therapeutically equivalent to the brand name drug." And, he adds, the consequences of such a policy are obvious. "These switched medicines contain a different active ingredient or, in some cases, a different delivery mechanism; which may lead to important differences in the medicine’s safety, efficacy and outcomes, and even uses that may be contrary to the indications approved by the Food and Drug Administration." You can read Dr. Popovian's op-ed in its entirety here.