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Mar17
Can Social Media Help Clarify The Debate Over Generic Medications? Help Me Find Out

This morning, the Los Angles Times published a story focusing on the ongoingresearch.jpeg debate over whether generic medications are really “just as good” as their branded counterparts. For many years, arguments that generics are not appropriate substitutes for expensive branded medications have been dismissed as drug industry propaganda.  However, anecdotal (and some scientific) evidence indicates that generics are not truly “bioequivalent.”

According to the LA Times: “A switch from a long-used brand-name drug to its generic equivalent can, on occasion, bring a shifting profile of side effects.  In a number of cases documented in medical journals and recounted in interviews with physicians, a generic version of what is often called a ‘pioneer’ drug simply doesn't appear to work as well for many patients.”

Two areas where generic drugs don’t appear to do as well as branded medications are epilepsy and depression.  Last year, American Epilepsy Society urged the FDA to conduct a study in order to determine “once in for all” whether generic medications increase epilepsy patients’ risk of seizures and adverse events.

 

Another study, conducted by an independent lab indicates that generic 300 mg Budeprion XL and its branded counterpart Wellbutrin XL work very differently in the body. According to the LA Times: “Both products released the same amount of bupropion hydrochloride  . . .over 16 hours, but the generic pumped out its active ingredient much faster than did the branded product: In the first two hours, the generic released a third of its active ingredient – four times as much as its brand counterpart.  At four hours, the generic had released almost half of its medicine, the brand-name about a quarter.”

This Looks Like A Job For . . . Social Media

Currently, there is little widespread clinical evidence that generic medications are not truly equivalent to their branded counterparts.  I’ve always been a strong believer in the power of social media to highlight and organize information about drug treatments.  If the “signals” from social media are strong enough, this may indicate that further study is needed.  

Regarding the debate over generics, I think social media can help in two areas:

1.    Determining whether physicians in the US and globally are seeing major differences in the safety and efficacy of many generic and branded medications.

2.    Highlighting patient reports of their experiences after being switched from a brand name drug.

So, are there social media companies (focusing on health) willing to help me answer these two questions?  If so, I’d love to hear from you.  If we get enough data from various sources, it might even be worth putting out a press release about our findings in order to inform the ongoing debate.  If companies are interested in working with me to conduct this experiment, please leave a comment below.  

3 Comments/Trackbacks




There is no doubt in my mind that generics are SOMETIMES different from the brand names, and one generic is usually different from another generic with the same ingredients. Differences range from the time it takes the drug to react to the effectiveness of the drug. Generally, I'm willing to cope with these differences and can usually work through them -- considering the cost of the brand name drug.

My big question, though, is why isn't there a generic insulin??? I've been waiting for this one for years!

In regards to the points you made about the safety and efficacy of the generic version of Wellbutrin XL, the FDA published these findings today and ruled that the generic version is the "interchangable" and "theraputically equivalent" to Wellbutrin XL. You can read the report here:
http://www.fda.gov/cder/drug/infopage/bupropion/TE_review.htm

The Benefits of Generic Medications: Is the Efficacy There?

More now than in the past, generic medications have been encouraged by prescribers at a much higher rate due to the problem of the high cost of branded meds that many find unfair and unreasonable. Branded meds are still prescribed often, though, mainly due to samples of such meds provided at a doctor’s office from the sales reps who promote these meds. Generics typically are not sampled due to lack of funds compared with branded pharmaceutical companies. Yet generics cost a small fraction, such as a third of the cost, of the same branded meds that have the same molecular bioequivalence. Yet not all branded meds have a generic formulation due to patent exclusivity and therefore cannot be produced until the expiration of this patent of the branded med. This is further complicated by possibly a degree of apathy with health care providers, who appear largely demoralized with aspects of the U.S. Health Care System. More likely, however, is that samples do, in fact, help out the patients.

Not long ago, generic meds were not prescribed that often, or produced to a great degree because of the cost of bringing such a med to the market, which at the time required the same protocols as branded meds. Fast forward to 1984, when the Hatch-Waxman Act was introduced, and this Act only required generic meds to demonstrate bioequivalence to the branded med that they desire to reverse engineer, and nothing else included in the approval process. The reduced cost of generic production allowed for more of these meds to saturate the market, and doctors started prescribing more generic meds as a result. Branded pharmaceutical companies were not pleased in large part with this new act, so they devised schemes to extent the patents of their branded meds, through such tactics as reformulation, which is called Evergreening, of their meds and frivolous patent infringement lawsuits, which delay generic availability for a longer period. Yet pharmacies support generic use, as they make more money off of generics compared with branded meds. So delays will not prevent the utilization of generics, overall.

Generics seem to remain a concern to branded companies in spite of their efforts of avoiding their access, as branded companies have progressively started producing their own generic meds along with their branded ones due to the increased use of generics.

Also, other reasons for increased generic prescribing is due to the awareness and clinical experience of the previous branded med that has been replicated by the generic med. Newer drugs at times are not a desirable choice of treatment for patients because of lack of confidence- safety being the main concern with some prescribers. So the familiarity of a generic equivalent of a known med creates a more reassuring choice for the prescriber. Available generics are listed in what is called an orange book. It should be available to all health care providers for their access.
Most encouraging for even greater use of generic meds is that at least one company has created vending devices for doctor’s offices for dispensing both generic and over the counter meds. This may discourage the use of branded equivalent meds at a greater amount with generic samples available as well as the branded meds. In addition, and in some cases, doctors can order generic samples from the manufacturers. I consider this device rather innovative.

Yet some doctors insist that you get what you pay for, so they are convinced that branded meds are always more efficacious and tolerable than generic meds. This misconception is a fallacy, since both forms are identical from a bioequivalence and bioavailability paradigm, as required for approval. I’m sure it’s possible others have encouraged such doctors to take such a stance void of fact and reason. Yet there may be some truth to decreased efficacy of generic meds over their branded equivalents.

Considering the health care crisis in our country and the over-priced treatment methods in our system, as with branded pharmaceuticals, generic medications should be considered when clinically appropriate for the benefit of those seeking restoration of their health. It would beneficial for patients to become aware of this pharmaceutical system and request generics when being prescribed a med by their health care provider. In other words, they should question authority figures such as doctors are perceived to be, as patients definitely have a right to acquire knowledge and use this for their benefit with situations as their choices for treatment options, as this will be for their financial benefits while improving their well-being with generic medications- an ideal way to reduce health care costs and improve compliance with their meds because generics are an affordable asset to public health.

“What good fortune for those in power that the people do not think.” --- Adolph Hitler

Dan Abshear

Authors note: What has been composed above is based upon informa

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