Methylphenidate for the poor, vs non-poor

[zelman]

Why not just write out a detailed post saying exactly what you mean?

Sosoo don't roll that way. They're like experimental jazz. Sometimes you've got to listen for the notes they aren't playing and sometimes you've got to listen to the sense they're not making. It's figuratively literally all right there, by not being there.

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[CetiAlphaFive]

Why not just write out a detailed post saying exactly what you mean?

Lol. I'm sure they would if they actually knew what they meant when the thread started.

Zelman is right.
You're witnessing the art of Sosoolonious Monk.
Basically, they loosely translate an emotion into words, then wait to decide what they actually mean after people blast holes in their original point.


Truly innovative memery.

 

[wagrxm2000]

if u read what u quoted, there was no mention of prescription drugs in that quote..

I'm not even going to try to understand you.

 

[owlegrad]

Lol. I'm sure they would if they actually knew what they meant when the thread started.

Zelman is right.
You're witnessing the art of Sosoolonious Monk.
Basically, they loosely translate an emotion into words, then wait to decide what they actually mean after people blast holes in their original point.


Truly innovative memery.

I like to think of it like a puzzle. What does this word salad mean? Sadly I’m not very good at it, it almost always turned out to mean something else.

 

[y0ssarian87]

You're witnessing the art of Sosoolonious Monk.

I always enjoy listening to "Straight, No Chaser"

Which, coincidentally, is also what I need after trying to make sense of her threads.

 

[CetiAlphaFive]

I always enjoy listening to "Straight, No Chaser"

Which, coincidentally, is also what I need after trying to make sense of her threads.

Can you imagine them doing stand up comedy? LOL

 

[CynicalIntern]

I like to think of it like a puzzle. What does this word salad mean? Sadly I’m not very good at it, it almost always turned out to mean something else.

It makes a lot more sense when you compare it to the people who complain that "they can't lose weight, even though all they eat is salad" (Salad, of course, being a euphemism for a big mac)

 

[CetiAlphaFive]

It makes a lot more sense when you compare it to the people who complain that "they can't lose weight, even though all they eat is salad" (Salad, of course, being a euphemism for a big mac)

I've had prescribers try to write "Mutual generic Phentermine medically necessary"

I scratch it out and call them back to tell them no

 

[BidingMyTime]

you know this isn't true b/c you already know methylphenidate (mallinckrodt) is Bx rated and hence shows non-bio equivalence. hence the crappy version exists.

No, actually I had no idea what specific manufacturer you were talking about, because you never specified in your original posts. There are many generic manufacturers of methylphenidate, and many of them are indeed AB rated (I'm not really sure what you mean by BX rated, but I'll assume you mean that to refer to a non-AB rated oral form of methylphenidate.)

Now, you probably aren't aware of this, but if a doctor writes for a name-brand oral medicine, you can only legally substitute AB rated medicines. If the doctor writes generically "methylphenidate" (and from what I've seen, few doctors do this), then you can fill it with the appropriate strength of methylphenidate, it doesn't have to be AB rated to a brand name, because the doctor didn't specify any brand name to compare it to.

Bear in mind, that even if a drug is not AB rated, if it is FDA approved, then it is, by definition, safe and effective to use. It doesn't mean it's crappy....it just means the dosing can't be compared to a brand name drug that is on the market.

 

[sosoo]

Bear in mind, that even if a drug is not AB rated, if it is FDA approved, then it is, by definition, safe and effective to use. It doesn't mean it's crappy....it just means the dosing can't be compared to a brand name drug that is on the market.

in your previous comment you said "all" generics show bioequivalence of brand drugs. you then went on and on defining bioequivalence as if you never heard of it in your career. re-read it if you have to. so then i pointed out BX rated generic methylphenidate being "non" bioequivalent.

 

[BidingMyTime]

in your previous comment you said "all" generics show bioequivalence of brand drugs. you then went on and on defining bioequivalence as if you never heard of it in your career. re-read it if you have to. so then i pointed out BX rated generic methylphenidate being "non" bioequivalent.

I keep forgetting that you are just a pharmacy student (and possibly just a pre-pharm student, you've never clarified that), and not a pharmacist. I mistakenly assumed that I didn't need to spell out basic definitions of things for you.

To quote from my "confusing" first post

What this means, different generic versions must have the same active drug, and that active drug must be released at the same rate, as the brand name drug they are being compared to.

I realize now that you didn't understand that just because drugs have the same generic names, this does NOT mean they are generic versions of each other. A methylphenidate that is not AB rated to say, Concerta, is NOT a generic version of Concerta. Even if they are the same strength and advertise the same release rate. So by definition, when I said "different generic versions", this could only refer to an AB rated methylphenidate, because legally "generic versions" and "AB rated" are the same thing. Of course, there are generic drugs that are legal to use and prescribe, that are not AB rated, but these drugs are NOT considered generic versions of any brand name drug.

I hope this further explanation helps clear things up for you. If not, I recommend you talk to your supervising pharmacist.

 

[CynicalIntern]

in your previous comment you said "all" generics show bioequivalence of brand drugs. you then went on and on defining bioequivalence as if you never heard of it in your career. re-read it if you have to. so then i pointed out BX rated generic methylphenidate being "non" bioequivalent.

You keep pointing out this Bx rated generic methylphenidate. Are you referring to the Methylphenidate ER that is not equivalent to Concerta?

You are aware, aren't you, that if you're substituting this product for a prescription that is written as Concerta, you are practicing improper substitution and breaking the law?

 

[Rouelle]

Lisinopril and losartan are not bioequivalent. That does not mean that losartan is “crap.”

 

[sosoo]

To quote from my "confusing" first post
....because legally "generic versions" and "AB rated" are the same thing.

that is where i disagree. can you point to where it says legally that generic must be AB rated? that they are the same thing? because they're not.

 

[sosoo]

Lisinopril and losartan are not bioequivalent. That does not mean that losartan is “crap.”

u do realize we are talking about AB rating right?

 

[sosoo]

You are aware, aren't you, that if you're substituting this product for a prescription that is written as Concerta, you are practicing improper substitution and breaking the law?

when i say they are "non"bioequivalent and BX rated, i was saying the same thing. which part of it wasn't clear? i thought that was bright as day.

 

[zelman]

u do realize we are talking about AB rating right?

See, this is what I'm talking about:

are there more to this story than what's in the mail? Medicaid ppl are getting one version of methylphenidate, and we have to save that version for them. whereas the general public gets the other crappy version of methylphenidate that poor ppl don't even want. if they're paying zero, why are they so demanding? and is it legal to save the crappy version for the general public, and the better brand for Medicaid folks "only?" what's the real story behind this discriminatory behavior?

Sosoo didn't use the letters "A" and "B" in that order at all. THAT'S HOW YOU KNOW THEY ARE TALKING ABOUT AB RATING! In case you missed it, the clue was that they didn't say "generic" either. It's so obvious.

 

[CynicalIntern]

that is where i disagree. can you point to where it says legally that generic must be AB rated? that they are the same thing? because they're not.

Are you not in an orange book state? Because this whole thread makes so much more sense if you aren't

 

[CetiAlphaFive]

that is where i disagree. can you point to where it says legally that generic must be AB rated? that they are the same thing? because they're not.

This is truly a masterpiece

 

[M0df]

This reminds me of the new CNN commercial... This is an apple.

 

[Rouelle]

u do realize we are talking about AB rating right?

I was actually making fun of the idiocy of some of the content of this thread by making a purposefully *****ic statement.

 

[CynicalIntern]

This reminds me of the new CNN commercial... This is an apple.

Excuse me, I was clearly talking about the orange book, not the apple book. I don't know what's wrong with you, I thought it was bright as day.

 

[owlegrad]

Comparing generics that Are not AB rated to one another is like trying to compare apples and oranges.

 

[sosoo]

Comparing generics that Are not AB rated to one another is like trying to compare apples and oranges.

that statement right there is golden. there's generic that are AB rated, and there's generic that "are not" AB rated. thats the point i was making. even though the generics "are not" AB rated, they are still generic. they're just not bioequivalent of the brand. but that doesn't mean they're not generic. hence, i find the statement by Cynical incorrect............... he said,
...."because legally "generic versions" and "AB rated" are the same thing.."
if Owlegrad believes that there are generics that are not AB rated, then clearly that statement by Cynical is incorrect...
they are not "the same thing."
i'm not sure why ignorant ppl are having a hard time understanding that.

 

[BidingMyTime]

...."because legally "generic versions" and "AB rated" are the same thing.."

I said that, and it is true. As I clearly explained in my explanation following that statement. Like I said, you need to talk to your pharmacist supervisor about this stuff, if you aren't explaining it. Or your college professor.

i'm not sure why ignorant ppl are having a hard time understanding that.

I'm not sure why a self-proclaimed pharmacy student like yourself is so certain that their understanding of this, or any other pharmacy subject, is greater than the knowledge of actual pharmacists on here. You have made it clear you do not understand how the Orange book, bioequivalence, expiration dating, vaccines, or whistleblowing works. Everyone is wrong sometimes, it's OK to admit that. Or if you are really that embarrassed about being wrong, then just stop talking about a subject, and everyone will quickly forget it. It's only when you double down, and keep posting obviously incorrect information that people lose respect for you.

 

[Deja]

My head hurts after reading this thread... sosoo you haven't made a clear point in this entire thread and clearly doesn't know what you are talking about, are you really a pharmacist?

lets get back to your original post that you never made clear... are you talking about the generic for Concerta? did the company memo say that you can only dispense the actavis generic if the doctor wrote for concerta? you do know there are many different forms of methylpenidate right? which one are you talking about?

when I first saw the title of this thread I thought maybe I was going to learn something new and this maybe about poor metabolizers vs non-poor....

 

[CetiAlphaFive]

that statement right there is golden. there's generic that are AB rated, and there's generic that "are not" AB rated. thats the point i was making. even though the generics "are not" AB rated, they are still generic. they're just not bioequivalent of the brand. but that doesn't mean they're not generic. hence, i find the statement by Cynical incorrect............... he said,
...."because legally "generic versions" and "AB rated" are the same thing.."
if Owlegrad believes that there are generics that are not AB rated, then clearly that statement by Cynical is incorrect...
they are not "the same thing."
i'm not sure why ignorant ppl are having a hard time understanding that.

So here's one thing I think you don't understand:

If you get a prescription for Concerts, and you dispense anything that doesn't say ALZA on it, that is a mis-fill.

What I've been keeping secret is that the generics are bioequivalent.

Johnson and Johnson, who owns the patent for the OROS system in Concerta, sued all of the companies producing generics.

Then, after Mallinckrodt was able to demonstrate bioequivalence to the FDA, thousands upon thousands of "parent" complaints mysteriously started getting mailed to the FDA.

I'm ssssuuuuurrreee Johnson & Johnson had nothing to do with that.

The FDA then made sure that the only "approved generic" is the brand name tablet dispensed in a generic tablet.

By "crappy", what Sosoo really means is "generics that have been sabotaged by Johnson and Johnson"

Sosoo is basically celebrating a drug company illegally keeping competition out

 

[CetiAlphaFive]

Also, you cannot substitute meds that are not AB rated, even if one is a "generic"

 

[wagrxm2000]

What do you guys do if you get a script for Endocet?

 

[CetiAlphaFive]

What do you guys do if you get a script for Endocet?

Delete the voicemail

 

[sosoo]

Also, you cannot substitute meds that are not AB rated, even if one is a "generic"

another golden statement.. theres generic that are AB rated, and theres generic that are not.. all these times thats all i been saying. generic and AB rated are not "the same thing," that someone else had claimed. why is it that difficult to understand?

 

[owlegrad]

that statement right there is golden. there's generic that are AB rated, and there's generic that "are not" AB rated. thats the point i was making. even though the generics "are not" AB rated, they are still generic. they're just not bioequivalent of the brand. but that doesn't mean they're not generic. hence, i find the statement by Cynical incorrect............... he said,
...."because legally "generic versions" and "AB rated" are the same thing.."
if Owlegrad believes that there are generics that are not AB rated, then clearly that statement by Cynical is incorrect...
they are not "the same thing."
i'm not sure why ignorant ppl are having a hard time understanding that.

Please do not try to use my posts to prove your point. For one thing it was mostly a joke. For another, I don’t think I meant what you think I meant.

 

[CetiAlphaFive]

another golden statement.. theres generic that are AB rated, and theres generic that are not.. all these times thats all i been saying. generic and AB rated are not "the same thing," that someone else had claimed. why is it that difficult to understand?

It's almost as if an AB rating is something that can be revoked.

Drug X is brand.

Two companies, Y and Z, produce AB rated generics.

FDA decides 4 years later that Z isn't AB rated.

What happens then?

Let me be clear, and please read this slowly, and read this slowly:

If you get an RX is written for brand, and a "generic" isn't AB rated, you cannot substitute the "generic" without calling the MD to confirm.

AND:

In Texas, you CANNOT change the name of a CII medication.

I.e. if a script is for Vicodin 5/300, you cannot change to 5/325.


So, if you're getting prescriptions with CONCERTA written on them and dispensing "crappy" methylphenidate, you're breaking Texas law.

EDIT:

To clarify for Sosoo-
In America, if someone puts a word in quotes, that is how you let the people reading know that they shouldn't take that one word literally.

 

[sosoo]

im not even going deep into anything. This is a simple discussion of what generic is and stupid ppl are struggling to understand. Wow.

 

[sosoo]

Please do not try to use my posts to prove your point. For one thing it was mostly a joke. For another, I don’t think I meant what you think I meant.

ok. so if you're twisting your own comment, then the opposite to what i said must be true. you actually believe generic and AB rated are the same thing. Wow.

 

[CetiAlphaFive]

im not even going deep into anything. This is a simple discussion of what generic is and stupid ppl are struggling to understand. Wow.

LOL. You are amazing. I truly enjoy your posts

 

[sosoo]

LOL. You are amazing. I truly enjoy your posts

Im interested in knowing your response to this. when someone say "generic and AB rated are the same thing." true or false?

 

[CetiAlphaFive]

Im interested in knowing your response to this. when someone say "generic and AB rated are the same thing." true or false?

Would you like me to explain it to you before or after I finish trying to teach a goldfish calculus?

 

[sosoo]

Would you like me to explain it to you before or after I finish trying to teach a goldfish calculus?

can u do both? i'll skip the part i don't need to read and just look for the true/false answer. this isn't calculus and does not need to be.

 

[zelman]

Im interested in knowing your response to this. when someone say "generic and AB rated are the same thing." true or false?

Honestly, since Venlafaxine ER Tablets (not a generic product) came to market, I couldn’t really define “generic” at all. I could do “generic drug” but not “generic product”.

 

[CynicalIntern]

The most frustrating part about this is that we still haven't even gotten confirmation that sosoo is talking about Concerta.

Also, I just wanted to say that referring to the class difference between medicaid and non-medicaid as "the poor" and "the non-poor" is kind of tasteless and reminds me of SHC.

 

[sosoo]

The most frustrating part about this is that we still haven't even gotten confirmation that sosoo is talking about Concerta.

Also, I just wanted to say that referring to the class difference between medicaid and non-medicaid as "the poor" and "the non-poor" is kind of tasteless and reminds me of SHC.

1. omg. yes i been talking about concerta vs the BX rated product. in summary, i been saying, it is not bioequivalent, but it is still a generic. its the essence of my argument. that is why i disagree when someone was saying "generic and AB rated are the same thing." because it is not. you have generic drugs that are "not" bioequivalent, but are still generic. so how can they be the same thing?

2. if the argument of poor and non-poor is tasteless to you, imagine how consumers feel when they are being discriminated. medicaid ppl get one product that is worthy for their use, while everyone else (non-medicaid) gets a different manufactured product. // then again this is no longer worth discussing b/c i'm the only one who received the company email. i made it clear from the original post that i wanted to see if anyone else knows the details behind this discriminatory behavior.

 

[CynicalIntern]

1. omg. yes i been talking about concerta vs the BX rated product. in summary, i been saying, it is not bioequivalent, but it is still a generic. its the essence of my argument. that is why i disagree when someone was saying "generic and AB rated are the same thing." because it is not. you have generic drugs that are "not" bioequivalent, but are still generic. so how can they be the same thing?

2. if the argument of poor and non-poor is tasteless to you, imagine how consumers feel when they are being discriminated. medicaid ppl get one product that is worthy for their use, while everyone else (non-medicaid) gets a different manufactured product. // then again this is no longer worth discussing b/c i'm the only one who received the company email. i made it clear from the original post that i wanted to see if anyone else knows the details behind this discriminatory behavior.

Oh, good, you formally responded to a question. Now let me ask you a follow up question to it. Are you in an Orange Book State? Because if you are, you cannot legally substitute this BX generic for Concerta for ANY patients, not just the medicaid population. Yes, there are generics that are not AB rated. You just can't use them unless the doctor specifies that they want to use them.

It sounds to me like your state medicaid department got sick of pharmacies illegally substituting a non bioequivalent methylphenidate ER product for Concerta, and took action to put an NDC block on it, and/or audit the hell out of the pharmacies who were billing it to the state. The act of correcting fraudulent activity perpetrated by you and your peers is not a discriminatory action, it just so happens that the state was the first to find a way to prevent it from happening. I would not be surprised in the slightest to see other insurance companies follow suit.

 

[CetiAlphaFive]

Here goes my attempt to explain

1. omg. yes i been talking about concerta vs the BX rated product. in summary, i been saying, it is not bioequivalent, but it is still a generic. its the essence of my argument. that is why i disagree when someone was saying "generic and AB rated are the same thing." because it is not. you have generic drugs that are "not" bioequivalent, but are still generic. so how can they be the same thing?

2. if the argument of poor and non-poor is tasteless to you, imagine how consumers feel when they are being discriminated. medicaid ppl get one product that is worthy for their use, while everyone else (non-medicaid) gets a different manufactured product. // then again this is no longer worth discussing b/c i'm the only one who received the company email. i made it clear from the original post that i wanted to see if anyone else knows the details behind this discriminatory behavior.

Company invent drug.
Only brand name. Because patent.

Patent go bye-bye.

Other company want to make drug.

FDA make them show it bioequivalent.
It have 2 B bioequivalent or they no make generic.

No generic before bioequivalent.

Can't be generic if no first be bioequivalent.

Ever.

Later, FDA come say
"you not bioequivalent no more!"

Drug was bioequivalent before become generic.
FDA can take away.

Generic Drug still same strength. Still same medicine.
Not bioequivalent.

Is still generic?

Pharmacist no can automatically substitute.

No-no. bad, illegal to substitute BX drug without call Doctor first.

Can't substitute C2.

 

[owlegrad]

ok. so if you're twisting your own comment, then the opposite to what i said must be true. you actually believe generic and AB rated are the same thing. Wow.

Wow. I don’t even know how to respond of this. I’m not sure I can follow what you’re saying at all. The fact that you can’t understand what that statement meant and what they were saying speaks volumes.

 

[CetiAlphaFive]

Wow. I don’t even know how to respond of this. I’m not sure I can follow what you’re saying at all. The fact that you can’t understand what that statement meant and what they were saying speaks volumes.

I can literally almost hear the saxophone blasting while the drummer swings triplets

 

[CynicalIntern]

Sosoo. Again. For the third time. I know you saw it, because you LIKED THE DAMN STATUS.

Are you
A) Not in an orange book state,
or
B) Upset that you have been told that you cannot illegally substitute products that are not equivalent to each other

 

[zelman]

Here goes my attempt to explain



Company invent drug.
Only brand name. Because patent.

Patent go bye-bye.

Other company want to make drug.

FDA make them show it bioequivalent.
It have 2 B bioequivalent or they no make generic.

No generic before bioequivalent.

Can't be generic if no first be bioequivalent.

Ever.

Later, FDA come say
"you not bioequivalent no more!"

Drug was bioequivalent before become generic.
FDA can take away.

Generic Drug still same strength. Still same medicine.
Not bioequivalent.

Is still generic?

Pharmacist no can automatically substitute.

No-no. bad, illegal to substitute BX drug without call Doctor first.

Can't substitute C2.

So, is phenazopyradine 200mg a generic?

 

[sosoo]

Are you
A) Not in an orange book state,
or
B) Upset that you have been told that you cannot illegally substitute products that are not equivalent to each other

A) that info is not relevant. i've taken 3 licensing exams in 3 different states and they never mention or ask about it. so its pointless for me to look up that info.

B) the company email was not about AB rating. b/c that applies to both medicaid and non-medicaid alike. regardless if the individual is on Medicaid or not, a Bx rated product cannot be substituted. im upset b/c of any discriminatory behavior.

 

[Corpseman]

Can someone eli5 because I can't understand /u/sosoo

What's the issue?