Friday, March 21, 2008

Generic--just as good?

…HA takes all generic drugs. She can’t afford the name brands and her insurance company isn’t enthused by them.

…As an educated amateur in the medical field, HA always believed that generics were “bioequivalent”—which she took to mean “just as good.” Sure, the cheap fillers in generics could kick up problems sometimes, but she really felt she was OK with generics.

…According to Melissa Healy, in the LA Times on March 17, 2008, the FDA insists generics are just as good. Same dose of the active ingredient, delivered in the same way, and manufactured according to the same standards of quality—as Healey put it in her piece.

…Often, though, according to stories in med journals and testimony from docs, generic versions of some drugs bring on different side effects.

…To say generics aren’t swell is like saying you don’t love your mother, one doc was quoted as saying.

…Recently, the American Epilepsy Society asked the FDA to do a large clinical trial to assess “for once and for all” if substituting generics risks problems in patients with epilepsy.

…One study of the generic for Wellbutrin was less effective in quelling depressive symptoms. The same lab that did that has asked the FDA to look at Toprol XL, the fifth most prescribed drug in America (high blood pressure).

…Cardiologists are reportedly worried about prescribing warfarin instead of Coumadin as a blood thinner (warfarin may have helped HA’s right eye go south).

…Other docs have questioned generic hypothyroid drugs and immunosuppressants.

…Of course, the generic drugmakers say the big pharmcos are trying to sow doubt.

…One doc said they were not saying all generics were bad, just that in some cases, it might make a difference.

…Generic drugs are not subject to the same approval process as the original drug. Period.

...So if you think you are not getting the result you’d like, ask the pharmacist. You can also check with to report adverse reactions. Contributing to these experiences is important.

…HA once felt horrible on a generic BP medicine. She decided this life was not for her. Sad. Miserable. The pharmacist said it could be the filler—he had heard other reports.

…HA still takes it because she can’t afford the brand name. She cowboyed up. Now many others will have to do that—especially on the anti-depressants, where that cowboying thing might not work so well.


Anonymous said...

What you need are custom pills. Who needs filler, especially if it is depressing? Can't they take all the active ingredients in the pills you take, put them in a machine and make just one pill with active ingredients, instead of all these different pills with fillers?

Otherwise you could move to Mumbai, I hear India has cheap meds.

Star Lawrence said...

Would that be those compounding pharmacists everyone is jumping on now for their "custom" hormones? Yes--I do think we need to look at new ways of doing things! I did not have Mumbai in mind. Costa Rica, Canada?

Matt said...

Has anybody had a negative experience with generic drugs? I’m looking to speak with a Minnesota patient who has been switched from a brand name drug to a generic and who could share their experience. If you are interested, please email me at