More than 1 brand?

[josh6718]

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Why do some drugs have more than one brand name (i.e. Jantoven and Coumadin for warfarin or Levoxyl and Synthroid for levothyroxine). We had a patient come through the drive thru the other day who's doctor had e-prescribed for levothyroxine- no brand medically necessary or other notes indicating that it should be filled a particular way. When she came to pick it up and found it was filled using the generic she flipped out started yelling.

Her: Why wasn't my prescription filled for brand. Don't you f***ing pharmacists go to school for this?

Pharmacist: I'm sorry, your doctor didn't specify and we didn't have any records of you taking this medication before. Do you know what brand you normally take- Synthroid, Levox---

Her: What do you mean? I just want the brand d*** it!

Pharmacist: Mam I apologize, but please let me finish, both are brands for levothyroxine.

Her: Okay whatever this is ridiculous, I'm just going to have my doctor call it into a different pharmacy that actually knows what they are doing!

 

[RockHardIce]

Don't know the answer to your question, but this reminds me of a lady who tired to convince the pharmacist that the pharmacist did not know that generics taste awful 👍

 

[Its Z]

Why do some drugs have more than one brand name

mmmm is this a trick question?

maybe because there are more than 1 company selling them and there is a trademark protection of the "brand" name?

 

[Momus]

Don't know the answer to your question, but this reminds me of a lady who tired to convince the pharmacist that the pharmacist did not know that generics taste awful 👍

I may believe the patient in this case... Brand drug sometimes taste better such as Sudafed... The generics do not have any sugar coating and taste horrible.

 

[litetigre]

Why do some drugs have more than one brand name (i.e. Jantoven and Coumadin for warfarin or Levoxyl and Synthroid for levothyroxine). We had a patient come through the drive thru the other day who's doctor had e-prescribed for levothyroxine- no brand medically necessary or other notes indicating that it should be filled a particular way. When she came to pick it up and found it was filled using the generic she flipped out started yelling.

Her: Why wasn't my prescription filled for brand. Don't you f***ing pharmacists go to school for this?

Pharmacist: I'm sorry, your doctor didn't specify and we didn't have any records of you taking this medication before. Do you know what brand you normally take- Synthroid, Levox---

Her: What do you mean? I just want the brand d*** it!

Pharmacist: Mam I apologize, but please let me finish, both are brands for levothyroxine.

Her: Okay whatever this is ridiculous, I'm just going to have my doctor call it into a different pharmacy that actually knows what they are doing!

Before answering your questions, first I want to say what a nice pharmacist, whenever patient use vulgar language, you don't have to say sorry. Tell them that pharmacist follow doctor order, it is the nurse fault not specify it.
Second, some old drugs have different brands because of many reasons: two companies file application at the same time before the exclusivity law, drug company wants different drug names for different indications, etc...

 

[owlegrad]

Before answering your questions, first I want to say what a nice pharmacist, whenever patient use vulgar language, you don't have to say sorry. Tell them that pharmacist follow doctor order, it is the nurse fault not specify it.
Second, some old drugs have different brands because of many reasons: two companies file application at the same time before the exclusivity law, drug company wants different drug names for different indications, etc...

I would not blame the nurse or the doctor. Something my boss told me at CVS, don't get into the blame game. It is unprofessional and you will probably lose. The patient won't believe you/care whose fault it is and if the patient relays the message to the doctor you can bet on an angry call.

 

[Ackj]

If there's no DAW, aren't you required to dispense generic? I know we've asked docs "this patient had brand last time, can you send us a DAW rx?"

Not sure if that's actual law, or just an insurance requirement.

 

[All4MyDaughter]

If there's no DAW, aren't you required to dispense generic? I know we've asked docs "this patient had brand last time, can you send us a DAW rx?"

Not sure if that's actual law, or just an insurance requirement.

The patient can request brand. Insurance may not pay for it. I've seen insurance companies refuse to pay for brand even when the prescriber has specified DAW. I guess this could vary by state law.

 

[Sparda29]

The patient can request brand. Insurance may not pay for it. I've seen insurance companies refuse to pay for brand even when the prescriber has specified DAW. I guess this could vary by state law.

Yep, in NY the patient cannot request a Brand. It must be generic unless the box on the bottom has DAW written in it. (DAW, not some lame checkmark.)

 

[owlegrad]

The patient can request brand. Insurance may not pay for it. I've seen insurance companies refuse to pay for brand even when the prescriber has specified DAW. I guess this could vary by state law.

All true, most of the time if the prescriber puts DAW you can bet it will be a prior auth reject. Or a nonsensical reject that once you call the ins turns out be a.......you guessed it, prior auth reject.

 

[pharm B]

Out of curiosity: the computer system I worked with had classes of DAW.

DAW-1 was doctor-specified, DAW-2 was patient-specified, and they had a few more. Was that a proprietary thing, or is this a billing thing that all pharmacies have? We haven't covered it in class yet, and I know it's basically how we tell an insurance company who wanted the brand.

 

[pharm B]

All true, most of the time if the prescriber puts DAW you can bet it will be a prior auth reject. Or a nonsensical reject that once you call the ins turns out be a.......you guessed it, prior auth reject.

My favorites! Nothing like going down the insurance rabbit hole while you're working the weekend shift, with plenty of patients breathing down your neck. 😉

 

[owlegrad]

Out of curiosity: the computer system I worked with had classes of DAW.

DAW-1 was doctor-specified, DAW-2 was patient-specified, and they had a few more. Was that a proprietary thing, or is this a billing thing that all pharmacies have? We haven't covered it in class yet, and I know it's basically how we tell an insurance company who wanted the brand.

It is not a proprietary thing, it is an industry standard thing. Everyone has the same codes. And yes it is for billing purposes. Only "cadillac" plans cover DAW2, I only remember like 2 patients who were able to pull that off. Silly anyway, if you want brand ask your doctor, not your pharmacist.

 

[owlegrad]

My favorites! Nothing like going down the insurance rabbit hole while you're working the weekend shift, with plenty of patients breathing down your neck. 😉

I love the nonsense codes! Why not just put f****** refill too soon?! Why must I call you for something as basic as that!? I know it is not because you love the sound of my voice.

Insurance is by far what I miss the least. Well, phones are a close second. I would love to try out a pharmacy on POWER or anything of that sort. The idea of some mystery person handling all that bulls*** for me off site sounds like the closest thing to heaven a retail pharmacy could be. I am sure I am idealizing it though.

 

[Jabberwocky12]

We get to use some of the other DAW codes here. In NC the state recognizes NTI while a lot of other states don't. So if a patient uses synthroid or levothroid or something along those lines they keep getting it until the doctor changes it.
I think that goes for coumadin and depakote as well. I should really get a list of those and know them by heart now that I think about it...


Apparently we're just weird like that.

 

[CUpharmD2013]

I love the nonsense codes! Why not just put f****** refill too soon?! Why must I call you for something as basic as that!? I know it is not because you love the sound of my voice.

Insurance is by far what I miss the least. Well, phones are a close second. I would love to try out a pharmacy on POWER or anything of that sort. The idea of some mystery person handling all that bulls*** for me off site sounds like the closest thing to heaven a retail pharmacy could be. I am sure I am idealizing it though.

I worked at a pharmacy on Sunday where the main number wasn't working and not many people knew the alternate number. The pharmacist and I had all the normal work done by 1 pm and listened to football all afternoon (awesome), dealing with the occasional customer who showed up and was like "your phones ain't workin." (No $%!%) I think a typical pharmacy could do 2 or 3 times the volume if it didn't have to deal with phone calls.

 

[Rockinacoustic]

Yep, in NY the patient cannot request a Brand. It must be generic unless the box on the bottom has DAW written in it. (DAW, not some lame checkmark.)

Reminds me of when a Nurse called and wanted to make sure her patient got brand metoprolol xl, because the generic wasn't working. I specifically said to her "make sure you have the MD write 'DAW' in the box."

Lo and behold the poor patient came in with an RX written: Toprol XL 50mg (brand)

 

[josh6718]

mmmm is this a trick question?

maybe because there are more than 1 company selling them and there is a trademark protection of the "brand" name?

Meaning that the original company would sell the manufacturing rights to another pharmaceutical company before their patent expired?

 

[PharmDstudent]

Meaning that the original company would sell the manufacturing rights to another pharmaceutical company before their patent expired?

In other words, the names themselves are copyrighted. Think of Advil and Motrin...

 

[Jabberwocky12]

In other words, the names themselves are copyrighted. Think of Advil and Motrin...

Maybe I don't get how this works but is that how authorized generics work as well? Maybe unoffically, but do pharma companies give patent information to another generic company (or own the generic company outright) in some kind of deal to expedite the generic process and maintain a foothold on the market a little longer?

I know for a while (maybe still) protonix had one authorized generic seller who did pantoprazole and they were umbrella'd if I recall. They both even had the same looking pills and both even had the word "protonix" written on them!
-- Some techs got into trouble with that for putting pills from a generic into a brand script or vice versa and screwing up inventory...

 

[genesis09]

We just got those "generic" pantoprazole. A number of the brands will make the generic as well. It's easy money for them.

 

[PharmDstudent]

I thought it was part of a brand name buyout?! Or at least that's what my old staff pharmacist had said

 

[1ive2die]

Why do some drugs have more than one brand name (i.e. Jantoven and Coumadin for warfarin or Levoxyl and Synthroid for levothyroxine). We had a patient come through the drive thru the other day who's doctor had e-prescribed for levothyroxine- no brand medically necessary or other notes indicating that it should be filled a particular way. When she came to pick it up and found it was filled using the generic she flipped out started yelling.

Her: Why wasn't my prescription filled for brand. Don't you f***ing pharmacists go to school for this?

Pharmacist: I'm sorry, your doctor didn't specify and we didn't have any records of you taking this medication before. Do you know what brand you normally take- Synthroid, Levox---

Her: What do you mean? I just want the brand d*** it!

Pharmacist: Mam I apologize, but please let me finish, both are brands for levothyroxine.

Her: Okay whatever this is ridiculous, I'm just going to have my doctor call it into a different pharmacy that actually knows what they are doing!

I don't know about the other drugs but I know for the thyroid hormone drugs like synthroid not all the brands are bioequivalent so it really matters what "brand" the patient is taking.

 

[Jabberwocky12]

I don't know about the other drugs but I know for the thyroid hormone drugs like synthroid not all the brands are bioequivalent so it really matters what "brand" the patient is taking.

Yeah in our state they are known as "narrow therapeutic index drugs."