The Economy and Generic Drugs

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MADISON-Down the hatch!

The expense of the daily dose of medicine is a bitter pill for many Americans. Yet, more than half of those taking prescription drugs are not taking advantage of an economical option: generic drugs.

The Food and Drug Administration (FDA) says 52 percent of Americans could save money by choosing generics over brand name drugs.

"The downward spiral of the economy may have many Americans considering a switch to lower-cost generic drugs," said Lee Vermeulen, a pharmacist and clinical associate professor at the University of Wisconsin School of Pharmacy.

"But there are people who will never, under any circumstances, switch from brand-name drugs to generics," noted Vermuelen about the strong bias against generic drugs.

"I don't think we'll ever completely dispel the myths about generic drugs. They are too ingrained in the consumer psyche," he added.

Vermeulen has expertise in consumer drug-buying habits as a researcher and director of the Center for Drug Policy at UW Hospital and Clinics.

Roughly half of the prescriptions in the U.S. are filled with generic drugs when Medicare, managed care plans and hospital dispensing of drugs are considered, according to Vermeulen. He attributes the relatively low percentage to widespread myths about the safety and effectiveness of generic drugs.

The most common myth? That less expensive drugs are inferior or not of the same high quality as brand-name drugs.

"People don't like change. And patients don't like the thought of using something that's cheap as opposed to inexpensive. The saying 'you get what you pay for' shouldn't apply to generic drugs," noted Vermeulen.

"For the majority of generic drugs, there is virtually no reason for bias. The Food and Drug Administration (FDA) requires that generic drugs pass the same rigorous standards as brand drugs," said Vermeulen.

When a drug patent expires, usually after 17 years, drug companies may produce generic versions of the drug. Generics must be tested and approved by the FDA.
Vermuelen noted that the companies can afford to sell generic versions at a dramatically reduced cost since they don't have the expense of developing a drug from scratch.

Many insurance plans offer low co-pays for generic drugs and much higher co-pays for brand drugs. Vermeulen said that in his experience, the bigger the gap between generic and brand name co-pays, the more readily patients will seek out generic drugs.

Vermeulen provides one caution for consumers about generic drugs

"Consumers should be alert about generic versions of narrow therapeutic-index drugs (NTI)," said Vermeulen.

Examples of NTI drugs are anti-seizure medications, blood thinners and anti-rejection drugs for transplant patients.

"For example, if someone is taking a particular brand-name blood thinner and their blood levels stabilize, switching to a generic could become problematic."

"With these drugs, there is a narrow window between effectiveness and toxicity. Even a small variance in blood levels could cause problems. Patients taking any drugs in this class should be monitored constantly so the level of medication can be tweaked to insure safe results," noted Vermeulen.

He said when a patient asks for a generic from the NTI class, pharmacists should make both patients and their doctors aware.

Vermeulen offered advice to consumers who may be considering generic medications:
  • Under FDA rules, generics must have the same active ingredients, purity, and labeling and deliver the same amount of active ingredients over the same time period.
  • Consumers considering generics should discuss the issue with their physician and be aware of narrow therapeutic index drugs.
  • Since generics are produced by several manufacturers and pharmacies may switch manufacturers, consumers should always ask pharmacists when the color or appearance of a drug changes. The pharmacy must include that information on the label or sticker on a drug container.

Date Published: 11/06/2008

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