Generic Bashing in the News

Just great.

This new article on the homepage for msn.com is just what I needed to freak out my patients about generics. We, as pharmacists, try to educate, educate, educate; and inflammatory articles like this just erase all that I try to teach my patients about generic substitution.

The article basically says that generics aren’t as good as brand-name medications. At the beginning….. then there is some better explaining.

This article wasn’t all that bad per se, but people need to read the whole thing. Unfortunately, most people will only read the headline and maybe a paragraph or two.

I, personally, don’t agree with the way my corporation goes about generics. They just send us whatever is cheapest from the wholesaler. That means with some drugs, I have to change the manufacturer every month.

I don’t think that I should substitute the generic for Synthroid or Levoxyl - and not because the generic versions of levothyroxine aren’t up to par (well, maybe Sandoz isn’t….lots of manufacturer recalls on that one), but just because I think that the generics shouldn’t be switched around on medications with a narrow therapeutic index. Same goes for warfarin. In my pharmacy, I make sure not to change around generics on diltiazem products (it is so confusing to remember which ones are AB rated), warfarin, thyroid preparations, or digoxin.

But, by and large, generics are exactly the same as the brand name medications. A lot of generic companies are OWNED by the brand name companies, and the tablets or capsules inside the bottles are identical (Lotrel and its generic by Sandoz, both owned by Novartis, is a good example of this). Greenstone generic company is owned by Pfizer, Dr. Reddy’s generic company is owned by Merck.

For most generics, the medication is THE SAME thing as the brand name drug.

The placebo effect is a real phenomenon. If people think that the medication they are getting isn’t as good as the one before, they will have have physical symptoms proving the “inferiority” of the new generic.

Dissolving two tablets in a test tube isn’t the same as the in vivo experience. To be granted FDA approval, Teva must have had to prove that their version of bupropion XL 300mg had a similar AUC to the brand name product. However, if one generic manufacturer’s version of a product is consistenly having problems, it is something that obviously needs to be addressed by the FDA. I hope that this doesn’t cause a panic