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.
Related Stories
Health systems representing around 500 U.S. hospitals have formed a not-for-profit pharmaceutical manufacturer called Civica Rx. The drugs will be cheap, and the CEO will not receive a paycheck:
A drugmaking venture backed by major U.S. hospitals has picked a chief executive officer, hastening the arrival of another threat to generic pharmaceutical manufacturers.
Martin VanTrieste, 58 and a former top executive at biotechnology giant Amgen Inc., will run the organization, a not-for-profit called Civica Rx. Dan Liljenquist, 44 and an Intermountain Healthcare executive, will be chairman. Health systems with a total of about 500 hospitals -- including Intermountain, HCA Healthcare Inc., Mayo Clinic and Catholic Health Initiatives -- will help govern the venture, alongside several philanthropies.
Civica Rx will work to combat drug shortages and skyrocketing prices for some treatments given in hospitals by manufacturing generics or contracting with other firms to make them. Generic drugmakers have faced scrutiny for raising the prices of certain older drugs, particularly when hospitals lack alternatives. The supply chain for such treatments has also been vulnerable to disruptions, leading to persistent shortages.
"Civica Rx will first seek to stabilize the supply of essential generic medications administered in hospitals," the group said in a statement. "The initiative will also result in lower costs and more predictable supplies of essential generic medicines."
The venture, announced by Intermountain in January, said it plans to have its first products ready by as early as next year. It's focused on a group of 14 drugs given in hospitals, but a spokesman for the group declined to identify them. Liljenquist said that the drugs are in categories such as pain relief, antipsychotics, antibiotics and cardiovascular treatments, including drugs that are stocked on so-called crash carts used in emergencies.
Also at NPR, CNBC, The Washington Post, and Forbes.
Related: The Cheerios Theory of Branded Medicine
Mylan Overcharged U.S. Government on EpiPens
Martin Shkreli Points Fingers at Other Pharmaceutical Companies
Amazon, Berkshire Hathaway, and JPMorgan Chase to Offer Their Own Health Care to U.S. Employees
Analysts Question Whether Curing Patients is a Sustainable Business Model
FDA Has Named Names of Pharma Companies Blocking Cheaper Generics [Updated]
(Score: 1, Informative) by Anonymous Coward on Tuesday August 23 2016, @11:01PM
Same ingredients but different formula can make a big difference. Case in point: Crystal Light sells a caffeinated strawberry drink mix that stains the hell out of a porcelain cup. Roundy's supermarkets sells an imitation Crystal Light caffeinated strawberry drink mix with the same ingredients, and not only does the generic imitation not leave stains, it acts as a stain remover. You can guess why I stopped buying Crystal Light.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @11:31PM
This poster is not messing when they talk about crystal light. I would not be surprised to find out it is the same ink they use for sharpies. It does not come out.
I gave up on most diet sorts of drinks anyway. They just make me more hungry which negates the effect I am after... :(
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @12:12AM
The clone of CL isn't necessarily intended to be chemically identical. I suspect the (alleged) clone uses a different kind of food-coloring, which is less likely to stain your particular stuff.
Now if the box or company claimed it to be chemically identical, that's a different matter. But it doesn't.
Apples to strawberries.
(Score: 2, Informative) by khallow on Wednesday August 24 2016, @12:26AM
(Score: 2) by Non Sequor on Wednesday August 24 2016, @02:14AM
I know I can't rule out the placebo effect, but the generic version of Claritin doesn't seem as effective for me as the brand name version.
Write your congressman. Tell him he sucks.
(Score: 2) by curunir_wolf on Wednesday August 24 2016, @03:02AM
Works fine for me. But, I'm a chemist. So ... some placebo effect?
I am a crackpot
(Score: 1) by Francis on Wednesday August 24 2016, @02:36PM
Possibly, or possibly there's something that's different about the particular generics involved versus name brand.
Unfortunately, they aren't necessarily completely the same. They're supposed to be, but they aren't always exactly the same.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @04:16PM
Dudes... dudes... dudes...
it is all placebo
we are all hypnotised
this one makes you bigger
that one makes you smaller
all of it, the power of suggestion
(Score: 1, Funny) by Anonymous Coward on Wednesday August 24 2016, @01:23AM
Clearly the food chemists who formulated Roundy's drink mix are geniuses who managed to invent a nutritious vitamin-fortified bleaching agent.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @06:22AM
Sounds like they left the mordant out of their formula.
(Score: 2) by Reziac on Wednesday August 24 2016, @02:11AM
Same with drugs. The filler used can vastly affect shelf life and how well it's absorbed. There's been good research on this with regard to thyroid preparations; dunno about other stuff, but that was enough to convince me.
And I'd worry about what the generic drink mix was doing to my teeth.
And there is no Alkibiades to come back and save us from ourselves.
(Score: 4, Insightful) by stormwyrm on Tuesday August 23 2016, @11:10PM
It's not a good analogy. Just as some people can distinguish Coke and Pepsi in a double-blind taste test, I imagine that some people would be able to similarly distinguish between Cheerios and Walmart-os in a double blind test. Food is eaten for its taste as well as for nutritional benefit, and the fact that Cheerios and Walmart-os have exactly the same nutritional profile means jack squat to those who prefer the taste of one over the other. Otherwise, we would all just be drinking Soylent or eating stuff like those calorie bars I tried in Japan and calling it a day.
It is not the same for pharmaceuticals. If they have the same active ingredients then they should have the same effects on disease. Mrs. Wyrm insists on branded medicines because she thinks that they're more effective, but I would bet that if I gave her generic mefenamic acid pills that looked exactly like the branded ones she is used to taking when she has dysmenorrhoea, she would experience the same level of relief. Only problem is the generic pills here look quite different (trademarks bah!) so it's not possible to fool her that way. I, on the other hand, don't care, and will go on happily taking my generic atorvastatin, amlodipine, and losartan as long as my blood pressure remains under control and my lipid profile remains within acceptable levels. The generic medicines I take are doing what they should.
Numquam ponenda est pluralitas sine necessitate.
(Score: 5, Informative) by quintessence on Tuesday August 23 2016, @11:31PM
It's not that clear-cut.
Oftentimes the secondary ingredients can have a pronounced effect on the efficacy of a medication. And it may not simply be a case of where the name-brand always works better. Some people have a better reaction to the generics.
This is more of a case where people who have little knowledge in the administration of medications make grand pronouncements about how things should work, but falls short in actual practice.
Formulations differ, there could be unusual reactions with the inactive ingredients (more if someone is on a slew of medications), or undoubtedly a bit of the placebo effect in action.
Not to be cheerleading for pharmaceutical companies, but several of the criticisms made are unwarranted.
(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.
(Score: 3, Informative) by Rivenaleem on Thursday September 01 2016, @12:28PM
It is not just the excipients that matter, but the process is highly influential on the end product. Diamond and Graphite are the same material, however their production highly differs.
When formulating a medicine, the process matters. How long is it mixed, is it high-sheer mixing, what temperature is it mixed at? What happens when you Lyophilise the drug product? How long does drying take, you can do it slow and steady to get one type of crystal, or fast and aggressive to get another. Which reconstitutes better? Some companies will take the extra time to formulate, fill and freeze dry their product because they are the luxury brands of the pharma industry. The efficacy may, as a result, be better than a generic that may or may not go to the same lengths.
Given that most generics are only copying a process, and are not the designers of the original formulation, I (disclaimer: work for a major pharma company) believe that branded medicines should be held to a higher standard than generics.
On the flip side, there are some formulations that are so simple, anyone can do it. The problem is in knowing which these are, which medicines for which it is perfectly fine to go for a generic.
(Score: 3, Interesting) by AthanasiusKircher on Wednesday August 24 2016, @01:20AM
It's not a good analogy. Just as some people can distinguish Coke and Pepsi in a double-blind taste test, I imagine that some people would be able to similarly distinguish between Cheerios and Walmart-os in a double blind test.
Meh. The example's not the best, but yours is perhaps better. You ever heard of the "Pepsi Challenge"? Study after study has shown that the number of people who think they can distinguish Coke and Pepsi is many times the number who actually can.
And if you try a triangle test (3 unknown sodas, 2 identical), approximately 1/3 will be able to correctly "identify" which two are the same (note here we're not even requiring them to correctly identify which is Coke and which is Pepsi). And obviously note that chance in such a test is 1/3, so it's basically random guessing. You do get results somewhat above chance going head-to-head (only two choices) in terms of correct identification, but then if you try any "funny business" like putting sodas in the wrong cans, dedicated Coke drinkers will swoon and praise the Pepsi out of a Coke can, even claiming to taste flavors they claimed were only in their preferred cola. (In general, those declaring "brand loyalty" or "strong preferences" basically come up no better on such tests than other people.)
My favorite are of course the fMRI studies, though. You taste the sodas blind, and preferences are split (though usually Pepsi comes out ahead). But you tell people what they are tasting, and they prefer the Coke by a wide margin -- and a different part of their brain lights up when they do so. Interestingly, when people have brain damage in that area, they don't seem to succumb to brand loyalty effects as much.
Point being -- while I agree that this analogy about Cheerios isn't the best here, placebo effects caused by brand loyalty are very strong and difficult to get around. In situations dealing with medical treatment, chances are that these placebo effects are quite strong for those convinced that the generic drug is the inferior "Pepsi" version.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @03:07AM
Personally, I don't like pepsi or coke, but I can tell the difference. Maybe the Australian variants are more different than the USA ones.
(Coke here does have sugar instead of HFCS, There may be other differences.)
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @01:48PM
Even if the US, the two taste different. Coke is more carbonated and Pepsi is sweeter.
(Score: 5, Insightful) by slinches on Tuesday August 23 2016, @11:12PM
The prices are so skewed because it isn't a free market. A free market implies equal access to information between buyer and seller, which isn't happening here. Everything the pharma companies are doing from the IP rights, to fighting for regulations on generics, to their choices in naming/branding are designed to inhibit competition. Combine that with the institutionalized practice of doctors (who do not have an incentive to minimize cost or make patients aware of their options) writing prescriptions and we have what we see here. Heck, even the patient frequently doesn't have an incentive to reduce costs since they pay a flat fee.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @11:51PM
ombine that with the institutionalized practice of doctors (who do not have an incentive to minimize cost or make patients aware of their options) writing prescriptions and we have what we see here.
You know what else sucks dick? Big Farma sales reps.
(Score: 2) by curunir_wolf on Wednesday August 24 2016, @03:06AM
I am a crackpot
(Score: 3, Interesting) by Anonymous Coward on Tuesday August 23 2016, @11:52PM
(Score: 5, Insightful) by art guerrilla on Wednesday August 24 2016, @12:25AM
when you hear Big Pharma boohooing about how darn much it costs to bring drugs to market, you might ask just how much they spend on R&D compared to marketing...
uh oh, they spend FAR MORE on marketing bullshit than they do actual R&D...
(AND that is with hiding a lot of marketing bee ess as R&D: 'researching' the color and shape of the pill, etc, which has NOTHING to do with its efficacy, and everything to do with 'presentation'...)
yeah, those are some pitiful alligator tears, Big Pharma...
and the re-purposing trick to extend patents, controlling research such that any negative trials never see the light of day, etc, etc, etc...
another institution NOT WORTHY of the blind trust they are given...
(Score: 1, Interesting) by Anonymous Coward on Wednesday August 24 2016, @01:51AM
Spending money on marketing has a higher ROI than research, so don't expect that to change.
You forgot the sarcasm tags when you say that people blindly trust Big Pharma. Many people think the industry formed a conspiracy to sit on cures and sell treatments. Pharma is probably one of the most distrusted industries.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @06:32AM
Can't the appearance of a pill/capsule affect the strength of the placebo effect?
(Score: 0, Troll) by Anonymous Coward on Tuesday August 23 2016, @11:24PM
http://www.nytimes.com/2013/06/25/business/justices-rule-generic-makers-not-liable-for-drugs-design.html [nytimes.com]
If you have a reaction to the drug and it was generic, there's no liability on the maker of the generic. Nor of the original maker of the brand.
(Score: 2) by curunir_wolf on Wednesday August 24 2016, @03:12AM
I am a crackpot
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @01:53PM
You shouldn't be able to sue either. Everyone is different, so some people will have adverse reactions and some won't simply because of their different genetics (different genes and proteins, different enzymes, different metabolisms, etc), so an adverse reaction to a drug is kinda like a tornado or earthquake, an "act of god" (as defined by the insurance industry) that you should simply note and then avoid taking that drug again.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @03:33PM
Your summary is misleading. They are not liable for effects caused by the active ingredient. BUT that's not the same as having no liabilities. If they manufacturing it incorrectly, for example, they WOULD be liable.
No medication is risk-free anyhow. People's bodies react differently.
(Score: 0) by Anonymous Coward on Thursday August 25 2016, @02:16AM
(Score: -1, Redundant) by Anonymous Coward on Tuesday August 23 2016, @11:39PM
I would recommend according to sources on the net to be on the look out for shape shifting aliens disguised as humans, who, like the hybrid humans+aliens, must consume human flesh to maintain their human appearance.
human flesh is being found more and more in common food today,
there exists a certain barrier in normal, everyday thought which hides the reality of these creatures and their hybrids along with the smell and taste of human flesh in common food as well as the scent of these creatures. they all smell the same. while the aliens and hybrids are safe within their homes, they prepare higher concentrates of human flesh in food because they can get away with it and unless you're in the right state of mind, you wouldn't smell the human flesh in the food. They use some type of masking agent so you normally can't smell the taint. They have been studying us for years upon years and much of what you hear coming from government/military experiments are just a preview of things to come.
a certain modification to the mind can bring the typical human into a different frame of mind where these... "things" can be smelt/detected. there are other effects which follow, too, but the frame of mind of the individual would often be too flooded with different events occurring within and outside of the human mind/body.
Never trust a mason or someone giving you food/drink out of the blue, even if you've known these people for your entire life. always buy food at random, never return to the same product more than # of dice rolls. Always buy food and drink in sealed containers. Look for typical "Illuminati/occult" symbols and don't purchase from these companies.
Things are not what they appear to be on Earth, unless you are enabled to really see. Then you'll probably wish you never had. (like in The Matrix where the delicious fake steak is being consumed and a deal struck)
(Score: 2, Disagree) by Anonymous Coward on Wednesday August 24 2016, @12:11AM
> If they have the same active ingredients
One major problem: the same chemical formula can have different physical shapes depending on how the atoms are arranged.
One of the most common problems with generics is CHIRALITY. Our bodies have many systems which use ONLY left- or right-handed versions of the same molecule.
From https://en.wikipedia.org/wiki/Chirality [wikipedia.org] : "Also, for artificial compounds, including medicines, in case of chiral-drugs, the 2 enantiomers show remarkable effect in difference of their biological actions. Darvon (Dextropropoxyphene) is a painkiller, whereas its enantiomer, Novrad (Levopropoxyphene) is an anti-cough agent. In case of Penicillamine, the S-isomer used in treatment of primary chronic arthritis, Whereas the R-isomer has no therapeutic effect as well it is highly toxic."
There are lots of other things - does the generic use the same 'filler'? The same quality of encapsulation?
This does not mean the "original" is better than generics - but it *is* to say that if you get medicine, it does NOT necessarily contain the enantiomer which gave the lab results that prescriptions are based on. Even the developers of a drug probably refined production methods post-development, and might not be selling what the FDA (or your local equivalent) passed.
(Score: 3, Informative) by Anonymous Coward on Wednesday August 24 2016, @01:54AM
(Score: 0, Troll) by Anonymous Coward on Wednesday August 24 2016, @05:12AM
> The FDA and equivalent organisations around the world I believe are not such idiots as to confuse their left hands with their right, and would have scientists working for them who understand all about chirality!
If only it were so simple!
Lots of medicines are racemic and we often don't know if one or the other or both contribute to medicinal effects (see: ibuprofen).
> generic medicines must have exactly the same active ingredients as their branded counterparts to qualify
Ok; so if I say that the L-entantiomer is active, and R- is inactive, then all that matters from my chemical process is a consistent L- yield. Which means the 'inactive' R- can be present at any level (or none). Except that... like with ibuprofen, we might be wrong, based on initial or in-vitro data, in assuming R- is truly inactive.
It is not unheard of for sources of chemicals to themselves acquire a new source, and alter the L-R ratio. And do you really think that every generic maker in the world is testing every batch with a mechanism that confirms chirality? Much more likely it's a simpler yield test that doesn't distinguish, and if the reaction proceeds apace... who finds out that the output has changed?
"Trust the scientists" unfortunately got us DDT, DEET, BPA and PTFE.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @05:45AM
They had fucking better be, or else the FDA or its equivalent regulatory agency would have reason to prevent their products from being imported into their areas of jurisdiction and punish everyone involved in doing so. Unless your regulatory agencies are so captured by special interests that the fox is guarding the henhouse, but that's a different problem.
By the way, trusting the scientists also told us that DDT, DEET, BPA, and PTFE were bad things and needed to be removed.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @03:41PM
Consider that the "name brand" maker can also get sloppy or take short-cuts. Let's not pick on just generics.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @07:10AM
(Score: 2) by tathra on Wednesday August 24 2016, @01:57PM
different isomoer combinations are noted as different drugs. i give you Dexedrine (d-amphetamine salts) and Adderal (racemic amphetamine salts) as proof of this. the implications are understood and monitored, however this might only be the case where it is known that the different isomers have different effects.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @01:56AM
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @12:19AM
All the "generic" brands of Cheerios I've tried taste different than the actual Cheerios brand. The clones are not necessarily bad, just taste different. I actually like the variety*.
But cloned cereals are not the same as cloned medicine: they don't claim to be a chemically identical replacement. At the most they'll say, "Compare to Brand X" and not "we are exactly like Brand X".
* Don't extrapolate that beyond food, please.
(Score: 1, Insightful) by Anonymous Coward on Wednesday August 24 2016, @01:13AM
they make the regulations that make the process expensive so small players can't play and yet in lot of cases they use public-funded research for their products and we still need to hear their whines
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @01:58AM
I complained to the doctors about the generic pain killers not being as strong as the brand name ones. All of them said the same thing... The generics can have up to 10% less than what the label says, where the brand name ones are right on the mark. But yeah, $780.00 for brand name vs $135.00 for generic... I have to pay for it myself so I'll take the cheaper ones.
(Score: 2) by PartTimeZombie on Wednesday August 24 2016, @04:09AM
The generics can have up to 10% less...
That would totally be illegal where I live.
(Score: 1, Interesting) by Anonymous Coward on Wednesday August 24 2016, @05:18AM
In Germany for example you'll see +/-3% marked on *food* - but not so in the USA, where +/-10% by weight is legal in *food* (and in the nutrient components ascribed to food).
In drugs sometimes dose dependancy (and thus the margin of error) is very small, and sometimes the opposite.
I'm not sure what laws govern truth in medical portion sizes, across countries.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @05:39AM
I bet your doctors are shitting you.
(Score: 2) by tathra on Wednesday August 24 2016, @02:02PM
i've heard the same rumor, but the FDA explicitly denies the possibility [fda.gov]. my bet is that this rumor began to explain the placebo difference of higher cost drugs being more effective [washingtonpost.com].
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @05:35AM
If this story were meant to trick you into giving some group of people money, who would that be?
(Score: 2) by bradley13 on Wednesday August 24 2016, @06:07AM
Yes, there are differences in formulation, and in rare cases this can be important. However, in the majority of cases, it's the active ingredient that counts.
However, a lot of the problem is deliberate obfuscation. On the list of medications allowed in Switzerland, if you want Ibuprofen, you can buy: Advil, Alges, Algifor, Amavita, Artofen, Aspegic, Bondin, Brufen, Contro-Schmerz, Coop Vitality, Dismenol, Dolo-Spedifen, Dolocyl, Dolomin, ... geez, I'm only at 'D', and the list just keeps going...
So the doctors, who are always under time pressure, name the first medication that comes to mind. The patients have no idea; if the doctor wrote "Dismenol", then that's what they expect. If that is an over-priced version, well, the pharmacy has no incentive to sell a cheaper product.
What's the solution? What if they prohibited the use of brand names for drugs no longer under patent? Sell drugs by their active ingredient, with footnotes for secondary information. In the unusual cases where the secondary stuff is important, the doctor can include it in the prescription.
Everyone is somebody else's weirdo.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @06:37AM
This is just about exactly what the Philippine generics act [lawphil.net] says. All medicines in the Philippines must have the generic name in a prominent box, and all physicians prescribing medication must give the generic name in addition to any brand names.
(Score: 2) by Capt. Obvious on Wednesday August 24 2016, @10:10PM
I'm not sure if that's true. The generic's profit margin might be higher. The pharmacy, as opposed to the doctor, also knows what all the generics are. They may even be legally required to present the generics.
Bottom line, the doctor knows less about drugs than the pharmacist. It should be the pharamacist who helps guide you to the right drug. Heck, they already catch more prescription drug conflicts than doctors do.
(Score: 2) by urza9814 on Thursday August 25 2016, @03:05AM
Well...I write some of the software those pharmacists are using, and maybe your local neighborhood pharmacist knows this stuff, but the ones at the big chain drugstores probably don't. Or if they do they aren't using it much. We use a third-party system for that -- when the pharmacist adds your prescription, they run a check of all your existing prescriptions against a database of known drug interactions, and any potential conflicts come back and give the pharmacist a big on-screen alert when they try to sell you the drug. If anyone is curious, the term to search is "Drug Utilization Review".
Of course, there's no reason we couldn't do something similar with generics. Pharmacist tries to sell a prescription and an alert pops up "A higher margin generic is available!" The doctors could do that too, and in theory they should have less profit motive behind the choice since they aren't the ones selling the drug (usually). Although there's still issues like visits/gifts from the pharmaceutical reps...