FYI: Risperdal now generic

[Anasazi23]

From APA Headlines:

Teva begins shipments of risperidone.
The Wall Street Journal (7/1, B4) reports, "Teva Pharmaceutical Industries, Ltd. received Food and Drug Administration approval for its generic version of schizophrenia treatment Risperdal (risperidone), developed by Johnson & Johnson (J&J) unit Janssen Pharmaceuticals. Janssen's market exclusivity for Risperdal expired Sunday." The company "said it has begun shipments." The Wall Street Journal's (6/30, Wang) Health Blog also covered the story.

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[TheWowEffect]

Way to go

 

[MBK2003]

Don't worry Janssen investors, the psychiatric unit where I moonlight is covered head to toe in orange Invega paraphenalia, right down the orange Invega Crocs worn by social work and nursing staff. And happily, I'll report that >50% of the patients on the unit have been switched to Invega during their stays. Go marketing!

 

[Chimed]

Don't worry Janssen investors, the psychiatric unit where I moonlight is covered head to toe in orange Invega paraphenalia, right down the orange Invega Crocs worn by social work and nursing staff. And happily, I'll report that >50% of the patients on the unit have been switched to Invega during their stays. Go marketing!

Well, I don't think that helps the argument that marketing doesn't influence psychiatry....

But, the "orange Invega Crocs" is a joke? Right?

 

[Faebinder]

Don't worry Janssen investors, the psychiatric unit where I moonlight is covered head to toe in orange Invega paraphenalia, right down the orange Invega Crocs worn by social work and nursing staff. And happily, I'll report that >50% of the patients on the unit have been switched to Invega during their stays. Go marketing!

Alright lets have an honest discussion.

Is it noticably better than risperdal control wise and side effect wise?

 

[MBK2003]

Is it noticably better than risperdal control wise and side effect wise?

How could anyone tell since the average length of stay is under 5 days? All I know is that patients keep bouncing back to the ER because Mainecare is not paying for the medication after discharge because they don't have an approved diagnosis (usually they are Mood Disorder NOS, Impulse Control Disorder NOS, or Intermittent Explosive Disorder by discharge diagnosis, although most are Axis II). Then I get stuck writing for 15 day prescriptions and handing out a voucher, so they'll leave the ER.

We had one guy with significant leukopenia once dose was above 3mg.

But, the "orange Invega Crocs" is a joke? Right?

No they are real, I've seen them for myself and the sad thing is that the staff has no qualms about wearing them on the unit. I'm almost dissappointed there aren't Jibbitz for the Crocs in the shape of a brain or the Invega capsule.

 

[marie337]

How could anyone tell since the average length of stay is under 5 days? All I know is that patients keep bouncing back to the ER because Mainecare is not paying for the medication after discharge because they don't have an approved diagnosis (usually they are Mood Disorder NOS, Impulse Control Disorder NOS, or Intermittent Explosive Disorder by discharge diagnosis, although most are Axis II). Then I get stuck writing for 15 day prescriptions and handing out a voucher, so they'll leave the ER.

In my limited experience this is very true. During my C/A psych rotation there was a particular doc at a local inpatient unit who was switching everyone to Invega. We would see them at CMH a few weeks later when they weren't taking anything because it wasn't covered and then we would just restart them on whatever they were on before. It created quite a mess.

 

[Anasazi23]

Alright lets have an honest discussion.

Is it noticably better than risperdal control wise and side effect wise?

It's not about efficacy or side effects, but rather, about titration, metabolism and interactions, they claim. In fact, they promote it as having similar efficacly and side effect profiles as its parent drug.

 

[whopper]

Risperidone may now be generic but don't expect any dramatic price improvements for some time.

Several meds that are generic are still very expensive. Generic Sertraline, Gabapentin, Bupriopion among several other psyche meds are still expensive, though cheaper.

Citalopram, Fluoxetine, carbamazapine among a few others are avaiable for only $4 a month, $10 for 90 days at several places now. These have been life savers for several people. However these meds have been long available as generics for years.

A generic at $75 vs $100 is still better, but won't mean much to someone who can't afford $75 in the first place. I'll still give out the generic though, because if anything, it'll save money to the managed care companies, which hopefully they'll transfer to the patients in the form of cheaper premiums.

By the way, I haven't noticed much of a difference (yet) between Risperidone & Invega, but per the studies, it should have lesser side effects & doesn't have to be taken as often--making it more user friendly.

 

[Anasazi23]

I'll still give out the generic though, because if anything, it'll save money to the managed care companies, which hopefully they'll transfer to the patients in the form of cheaper premiums.

...no, that's sweet. You're a good guy whopper. I don't care what anybody else says.

 

[whopper]

Heh, yeah, wishful thinking I know.

Anyways, last year when I was Chief at my program, I told all the residents to prescribe generics if there was on available. I just got sick of seeing so many attendings give out lexapro, even to patients that could not afford it and had no way of paying it. They just wrote it down and never asked the patient about their means of paying for it. All the while Citalopram's only $4/month. (also got sick of attendings prescribing tegretol when carbamazepine is only $4/month)

Lots of these patients came back a few weeks later, noncompliant on their meds because they couldn't afford it, and then guess what? Attending writes a prescription for the same med they can't afford.

I calculated in 1 month's time how much money would've been saved if every patient prescribed lexapro was given the equivalent dosage of citalopram instead and it was in the thousands of dollars. I figure if every doctor giving out lexapro instead strongly considered citalopram first, especially for the patients that couldn't afford it, then for the system's sake, over $50,000 would be saved. Granted, there are differences between the 2 meds, but you guys get the point.

I think it was having a dramatic effect on Lexapro's sales in my area. Why? Well aside that I started seeing citalopram prescribed much more by my own residents & that the number of noncompliant (due to inability to pay the med) dramatically dropped, Forest Labs starting hosting a bunch of drug dinners aimed at the residents where the speakers kept mentioning it was better than citalopram.

 

[Faebinder]

Heh, yeah, wishful thinking I know.

Anyways, last year when I was Chief at my program, I told all the residents to prescribe generics if there was on available. I just got sick of seeing so many attendings give out lexapro, even to patients that could not afford it and had no way of paying it. They just wrote it down and never asked the patient about their means of paying for it. All the while Citalopram's only $4/month. (also got sick of attendings prescribing tegretol when carbamazepine is only $4/month)

Lots of these patients came back a few weeks later, noncompliant on their meds because they couldn't afford it, and then guess what? Attending writes a prescription for the same med they can't afford.

I calculated in 1 month's time how much money would've been saved if every patient prescribed lexapro was given the equivalent dosage of citalopram instead and it was in the thousands of dollars. I figure if every doctor giving out lexapro instead strongly considered citalopram first, especially for the patients that couldn't afford it, then for the system's sake, over $50,000 would be saved. Granted, there are differences between the 2 meds, but you guys get the point.

I think it was having a dramatic effect on Lexapro's sales in my area. Why? Well aside that I started seeing citalopram prescribed much more by my own residents & that the number of noncompliant (due to inability to pay the med) dramatically dropped, Forest Labs starting hosting a bunch of drug dinners aimed at the residents where the speakers kept mentioning it was better than citalopram.

Nice.

The problem is that the patent in the US gives 20 years of coverage for drugs that cover the time before the production. In some cases like Lexapro the time was only 4 years which left 16 years of protected production! (That makes it valid till 2017!) The average amount of years for "time to produce" a drug is more like 11-13 years. It's funny how it came out 2 years before the end of Celexa patent. Reverse engineering is so good that it can produce a drug in generic form within a few years.

We all agree, go for generic whenever generic is possible. Sooner or later the companies flood their markets with so many products that they wont make much of a profit from yet another SSRI and need to start focusing on actually finding a better class of drugs or sponsering research to actually uncover better understanding of the disease process.