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It has the same active ingredient, so it should work the same, but if someone says 'I want Cheerios, not Walmart-os', then why should they not get what they're paying for? (David Maris, pharmaceuticals analyst at Wells Fargo, as quoted in Staying Power, David Crow, Financial Times [Log in required], Aug 22.
Discovering a drug and bringing it to market can take more than 10 years and costs on average $2.6bn per medicine. Typically around five to seven years after, the exclusive rights on the discovery expire, and generic copycat versions quickly flood the market. Prices are slashed to super-cheap, and then for all time and eternity, society benefits greatly. Or, in the words of Pfizer's CEO Ian Read during an investor call: "The price of medicines drop significantly once the patent expires... Today, about nine out of ten prescriptions in the US offer generic drugs, which lead to significantly reduced costs in the healthcare system."
A recent Financial Times analysis doesn't completely agree though. Prices of branded medicines aren't slashed once the patent expires. They actually often sharply increase.
Before companies get to that phase however, a whole slew of other tactics have been used to maintain exclusivity. Many make small changes to a drug, then renew the patent. This is known as evergreening. Others "pay for delay" -- offering financial incentives to the generics producers to bring their alternatives to market more slowly. And once the generics get to market, pharma companies change tactics by attempting to stop patients, doctors and pharmacists from switching.
The end result is price differences between generics and brand medicines which are somewhat strange for a free market: Wellbutrin (bupropion, 150 mg) [Valeant]: $36 per pill versus $0.46 for the generic [bupropion]; Lipitor (atorvastatin 20mg) [Pfizer] 10.49 versus 0.13, Abmien (zolpidem 5mg) [Sanofi] 15.52 versus 0.02, Prozac (fluoxetine 20mg) [Eli Lilly] 11.39 versus 0.03, Xanax (alprazolam 1mg) [Pfizer] 8.14 versus 0.05 and Sarafem (fluoxetine 20mg) [Allergan] $15.98 versus $0.03 per pill.
There must be lot of people who prefer Cheerios over Walmart-os.
(Score: 3, Insightful) by stormwyrm on Tuesday August 23 2016, @11:41PM
Numquam ponenda est pluralitas sine necessitate.
(Score: 4, Informative) by Anonymous Coward on Wednesday August 24 2016, @01:40AM
Consider a solid pill consisting of a drug powder mixed with something that is effectively glue. The glue varies.
Kevin has strong stomach acid. Bob has weak stomach acid. Kelly has lots of bile. James has very little bile. Lucy eats lots of oily food. Dan hasn't gotten over the 1980's, and has an oil-free diet. William is a day-drinker, never to be seen without his vodka. Robert loves grapefruit juice, which is well-known for effecting absorption. Lauren is always constipated because she avoids water and fiber and because she likes her methadone. Paul usually has the runs.
The type of glue matters.
(Score: 4, Funny) by Anonymous Coward on Wednesday August 24 2016, @03:03AM
You have a bunch of weird friends.
(Score: 5, Insightful) by frojack on Wednesday August 24 2016, @04:44AM
Consider a solid pill consisting of a drug powder mixed with something that is effectively glue. The glue varies.Consider a solid pill consisting of a drug powder mixed with something that is effectively glue. The glue varies.
The generics are usually using the same glue. There's a reason they are listed as inert ingredients. Its because they are inert.
The glue is the cheapest part. Its not patented. When the patent on the medication expires there is no reason to change the formula at all.
Most people taking the drugs listed in the story have generics prescribed for them by their doctors. Not the original.
I had this conversation with my cardiologist last year. Doctors prescribing these days START with generics. They know that's where you will wnd up anyway, and the differences in the effectiveness is immeasurably small.
A drug on the market long enough for generics to appear is WELL understood. You might have a discussion about the effects of inert ingredients when a drug is NEW, but by the time the generics arrive that conversation is long over.
No, you are mistaken. I've always had this sig.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @06:17AM
Jezebel went forty days
drinking nothing but Perrier.
Dinah drove her Chevrolet
into the San Francisco bay.
(Score: 2) by deathlyslow on Wednesday August 24 2016, @12:46PM
88 lines about 44 women. I still have that somewhere. Gotta love Dr. Demento.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @01:44AM
IIRC there was an experiment on OTC pain meds compared with generics and whichever one was placed in the "brand name" packaging did the best. Marketing seems to enhance the placebo effect.
(Score: 1) by ewk on Wednesday August 24 2016, @02:05PM
Marketing IS the placebo effect...
I don't always react, but when I do, I do it on SoylentNews
(Score: 2, Informative) by Francis on Wednesday August 24 2016, @02:01AM
It's rather complicated as generics can be the result of patents expiring in which case the generic should be more or less exactly the same as the name brand as they're allowed to use the same processes to produce the same compound. However, even if the patents aren't expired, sometimes they're allowed to use a different process by which to create the same compound as the company patented the process rather than the molecule.
The big differences though tend to be how the pill is shrouded. The patents for the time release mechanism isn't necessarily on the same timeline as the medicine that it's delivering. The result is that you can have two pills delivering the same medication, but doing so at different rates. Somebody might be fine with the name brand and not the generic. But, some people don't tolerate the name brand, but do fine with the generic. Most people will do fine with either one.
The other difference is that generics are often times manufactured overseas and the FDA doesn't necessarily have time to visit those factories as regularly and as a result there may be mistakes made that won't show up in the medications produced in the US.
But, there's no doubt that the placebo effect of a name brand versus generic can have an impact. Some types of medication, like most used for mental illness are notoriously susceptible to working or not based upon ones belief about their efficacy.
(Score: 3, Informative) by frojack on Wednesday August 24 2016, @05:12AM
True about expired patents making the original formula as well as the original fillers both fair game.
But most people aren't getting prescriptions for the original manufacturer's long established drugs like atorvastatin or those listed in the story. The drugs are well understood, and most docs just prescribe the generics, never bothering with the original.
If you don't tolerate it, they move you to a different drug. They aren't going to experiment moving you from/to the original or the generic.
But the story seems to miss the common tactic of the original manufacturer where they tweak the formula to manage toleration and side effects, (or something far less important) and use the same brand name. So a doctor MIGHT have reasons not to use the generics, because its not even the same drug by that time. Incremental tweeks coming out every 4 years can extend a patent for a long time.
No, you are mistaken. I've always had this sig.
(Score: 1) by Francis on Wednesday August 24 2016, @02:39PM
In my experience, it really depends on the class of medication. For some things there are a few choices, for other things there really aren't. And both professional history and lobbying by pharma reps can effect what the doctor does in situations like that.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @06:10AM
Some are fine--or passably so--with homeopathy, else it wouldn't exist.
(Score: 2) by tathra on Wednesday August 24 2016, @01:44PM
for drugs, its the placebo effect. more expensive placebos are more effective [marketplace.org], so given everything else as identical, more expensive drugs have an additional placebo effect of being more effective over their cheaper generic versions.