Generic vs. Brand Name

[qian925]

I'm doing a presentation on generic versus brand name drugs and I was wondering if anyone can recommend any good and reliable websites on the topic. I found the usual web md and such, but as professionals or soon-to-be professionals of this field, are the two really the same? I've heard everything from the two are exactly the same except for the manufacturers and some people told me that the only difference are the fillers they use for the pills. What are fillers? And where can I find more information on this issue? Thanks.

[jdpharmd?]

Originally Posted by qian925

I'm doing a presentation on generic versus brand name drugs and I was wondering if anyone can recommend any good and reliable websites on the topic. I found the usual web md and such, but as professionals or soon-to-be professionals of this field, are the two really the same? I've heard everything from the two are exactly the same except for the manufacturers and some people told me that the only difference are the fillers they use for the pills. What are fillers? And where can I find more information on this issue? Thanks.

Search for a certain study that was done a while back; the results were that the generic synthroid was more consistent than the brand name product. Also check out the FDA's Orange Book online for some good info...

http://www.fda.gov/cder/ob/docs/preface/ectablec.htm

[GravyRPH]

Originally Posted by jdpharmd?

Search for a certain study that was done a while back; the results were that the generic synthroid was more consistent than the brand name product. Also check out the FDA's Orange Book online for some good info...

http://www.fda.gov/cder/ob/docs/preface/ectablec.htm

Ahh yes, the study that was funded by the makers of Synthroid. You could also search for the other study that showed that there was as much difference between different lots of brand Synthroid as was between brand and generic. And the ensuing class action lawsuit for the misleading claims that Synthroid drug reps brain washed pharmacists into believing.

[GravyRPH]

Originally Posted by GravyRPH

A class-action lawsuit was settled against Knoll Pharmaceutical
Company, the makers of Synthroid, which is used to treat thyroid
disorders. The plaintiffs alleged that Knoll delayed the publication of a
study it commissioned that concluded that less expensive brand-name
and generic versions of Synthroid were equivalent to and could be
substituted for Synthroid. Despite the study, Knoll continued to tell
federal regulators, pharmacists, and the medical community that there
was no substitute for Synthroid, and it made similar claims in advertising
to consumers. The suit was settled for over $150 million, with $107
million going to consumers..

see here: http://consumerlawpage.com/article/gouging.shtml

In sum, Knoll sponsored a research study and, when it found the conclusions to not be to its taste, embarked upon a campaign of scientific distortion and legal threats. Six years after the study’s completion, and over one year since it passed peer review in a prestigious medical journal, the investigators’ manuscript has still not been published, and, due to Knoll’s publication of its own self-serving article, may now not be publishable. These events would not have occurred had the FDA adequately regulated levothyroxine and provided adequate guidelines on bioequivalence determination. The FDA has essentially permitted the pharmaceutical industry to regulate itself in this area, with predictable consequences. However, the suppression of these findings, which have enormous implications for the practice of clinical medicine and cost-containment, would not have occurred had UCSF not failed to review the contract and then succumbed to the gag clause, thereby sounding a retreat from the time-honored principle of academic freedom. The public has been ill-served by both of these institutions.

[Sosumi]

Thanks for posting that, GravyRPh. All of the pharmacists I've worked with are so confused about switching to brand Synthroid or not because of the disinformation and uncertainty. (We usually keep them on brand Synthroid if they're refills and only give Levothyroxine for new prescriptions). It's good to know now and to assure patients and pharmacists that Levothyroxine is safe and effective enough to be substituted for Synthroid.

[GravyRPH]

Originally Posted by Sosumi

Thanks for posting that, GravyRPh. All of the pharmacists I've worked with are so confused about switching to brand Synthroid or not because of the disinformation and uncertainty. (We usually keep them on brand Synthroid if they're refills and only give Levothyroxine for new prescriptions). It's good to know now and to assure patients and pharmacists that Levothyroxine is safe and effective enough to be substituted for Synthroid.

Synthroid tends to be cheap and most insurances give you a low co-pay. I have no qualmst about switching, but I normally won't go out of my way to change a patient from one to the other. And many, many, many people will argue that they should never be changed. I'm sure some will crop up here to rebutt these statements. Anyone out there?

My primary job is hospital. I work weekends sometimes at a retail pharmacy. I had a patient who was discharged from my hospital come into me at my retail job and tell me he had to have brand Lanoxin because that is the only thing that works for him and that is what he had in the hospital. I had to informe him that, in reality, he was on generic Lanoxin for his entire stay and that his outcome was decidedly good. Realize, most patients in hospitals are unkowingly on generics and have excellent responses.

[Caverject]

Originally Posted by GravyRPH

Synthroid tends to be cheap and most insurances give you a low co-pay. I have no qualmst about switching, but I normally won't go out of my way to change a patient from one to the other. And many, many, many people will argue that they should never be changed. I'm sure some will crop up here to rebutt these statements. Anyone out there?

My primary job is hospital. I work weekends sometimes at a retail pharmacy. I had a patient who was discharged from my hospital come into me at my retail job and tell me he had to have brand Lanoxin because that is the only thing that works for him and that is what he had in the hospital. I had to informe him that, in reality, he was on generic Lanoxin for his entire stay and that his outcome was decidedly good. Realize, most patients in hospitals are unkowingly on generics and have excellent responses.

ARE YOU CRAZY!?!? You shouldn't switch Synthroid!!! just kidding I can agree with you here!

There are certain things I would be uncertain to switch to a generic on. Lanoxin is one of them. However, if the hospital pharmacy keeps the same brand in stock 100% of the time, I don't have a problem dispensing generic Lanoxin. In the State of Florida, we by law can only dispense Lanoxin and Synthroid if that is what is written. (We have a negative formulary) The other drugs I don't like to switch is birth control pills when a patient has been on it for a long time.

[GravyRPH]

Originally Posted by Caverject

However, if the hospital pharmacy keeps the same brand in stock 100% of the time, I don't have a problem dispensing generic Lanoxin.

Ya, but these people come in taking brand.

[chloejane]

Just curious, but how do you feel about generic coumadin vs. generic? When the generic first came out the pharmacy I worked in was not willing to stock it because it was not established and some patients can be senstive to changes...

As to the OP...the definition of fillers was explained to me a long time ago as being the non-active ingredients that basically held the meds together, but from personal experinence, there can be allergic reactions to fillers. I was switched from a brand name BC to the generic when it became available, and I developed a rash and my skin started peeling (gross, I know, but an example)- switching back to the brand rectified the problem over time.

[dgroulx]

Originally Posted by chloejane

Just curious, but how do you feel about generic coumadin vs. generic? When the generic first came out the pharmacy I worked in was not willing to stock it because it was not established and some patients can be senstive to changes...

I rarely see prescriptions for Coumadin anymore. Just about everyone is started on Warfarin. I wouldn't switch someone, though.

[Sosumi]

To the OP, fillers are something you'll be sick of discussing when you take pharmaceutics. They're supposed to be the non-active ingredients added to improve the ease of manufacturing the tablet or capsule and help with disintegration, dissolution, and absorption of the drug.

[Caverject]

Originally Posted by GravyRPH

Ya, but these people come in taking brand.

The hospital I used to work at would get a different mfg every couple weeks cause of price. Some generic brands we got were noticibly different.

Originally Posted by qian925

I'm doing a presentation on generic versus brand name drugs and I was wondering if anyone can recommend any good and reliable websites on the topic. I found the usual web md and such, but as professionals or soon-to-be professionals of this field, are the two really the same? I've heard everything from the two are exactly the same except for the manufacturers and some people told me that the only difference are the fillers they use for the pills. What are fillers? And where can I find more information on this issue? Thanks.

Fillers are necessary for the manufacturing process, but do nothing more for the pill itself than take up volume. The pill must be large enough for human fingers to readily handle. Even some small pills are quite a bit larger than the active ingredients they contain. Some common fillers are lactose (milk sugar), microcrystalline cellulose, corn starch, sugars (including sucrose, mannitol, sorbitol, fructose, dextrose), whey and yeast.

i found this on http://www.karemor.com/index.adp?url...dp%3Fid%3D1004
....you can google it for more information.

[ZpackSux]

The last thing a drug rep wants to hear from me is.."oh when is your drug going generic?" Then again I ask that everytime.. makes their heart skip a beat or two.

Brand vs Generic is a huge huge topic. The most basic topic should discuss the equivalency between Brand vs Generic.

Then you could present the patent issues.. little bit more involved. Good example is the Erythropoetin. Epogen by Amgen and Procrit by OrthoBiotech. Who owns the patent..and which is the generic??? Hmmm...

Why hasn't Rocephin gone generic yet..after 20 years on the market???

Another interesting topic... is the marketing and manufacturing practice of pharmaceutical industry regarding their drugs going generic.

1. Some co will manufacture both brand and generic and have the generic packaged by a generic co.
2. Some co will sligtly increase the price of their brand drug right before the drugs go generic...but they will introduce an isomer of the brand drug as the next best thing.. Claritin to Clarinex, and Prilosec to Nexium.
3.. Some co will buy and sell their generic line.. Seems like Baxter ends up buying all the generic antibiotics and sell them as frozens.
4. Biotech co will simply attach a PEG molecule to their drug..and present you with once weekly dosing drugs.. ie Aranesp.
5. Why does Diprivan costs $70 per bottle but Propofol costs $38?

Generic = Losing Patents...gotta love it.

It's a big and interesting topic... I would love to give this presentation.

Originally Posted by qian925

I'm doing a presentation on generic versus brand name drugs and I was wondering if anyone can recommend any good and reliable websites on the topic. I found the usual web md and such, but as professionals or soon-to-be professionals of this field, are the two really the same? I've heard everything from the two are exactly the same except for the manufacturers and some people told me that the only difference are the fillers they use for the pills. What are fillers? And where can I find more information on this issue? Thanks.

[Caverject]

Originally Posted by ZpackSux

1. Some co will manufacture both brand and generic and have the generic packaged by a generic co.

for clarity, an example would be Percocet/Endocet & Restoril/Temazepam