About those Generic Drugs

Everyone likes generic drugs.  So do I.  Who wants to pay those shocking prices–you know, a couple bucks or even a few bucks a pill for potentially life-saving products:  I mean, the gall of those pharmaceutical companies!–when a generic is out there for pennies on the dollar?

Seriously, it’s great to save money.  But it appears that not all generics are equivalent to the name brands.  Reports the Los Angeles Times:

 The Generic Pharmaceutical Assn. touts them with a slightly catchier slogan: “Same Medicine. Same Results.” But sometimes, patients and their doctors beg to differ.

A switch from a long-used brand-name drug to its generic equivalent can, on occasion, bring a shifting profile of side effects. In a number of cases documented in medical journals and recounted in interviews with physicians, a generic version of what is often called a “pioneer” drug simply doesn’t appear to work as well for many patients.

“Everybody thinks generics are swell: To suggest otherwise is like saying you don’t love your mother,” said Dr. Peter R. Kowey, chief of cardiovascular diseases at the Philadelphia area’s Main Line Health System, who reviewed the issue of generic substitution of certain heart drugs for the American Heart Assn. But between some pioneer drugs and their generic imitators, Kowey said, “we are concerned that the margin of difference is large enough” to risk patients’ health.

Last December, the American Epilepsy Society called on the FDA to approve a large clinical trial to determine “once and for all” whether the substitution of brand-name drugs with generics increases the risk of “breakthrough” seizures or toxicity among patients with epilepsy. This type of research would probably take years. But until such a study is completed, the society declared, it would oppose measures by state, federal or private insurance programs that would limit physicians’ choices in prescribing anti-seizure medicines.

Last fall, an independent laboratory, prompted by a flurry of consumer complaints, presented evidence that a generic version of the once-a-day antidepressant Wellbutrin XL may be less effective than the original at reducing some patients’ depressive symptoms. An agency spokeswoman said the FDA is investigating the matter and will make its findings public when the inquiry is complete.

In a report released today, the New York-based ConsumerLab.com, which conducted the Wellbutrin XL analysis, also urges the FDA to review the performance of a new generic for Toprol XL, a once-a-day version of a high blood pressure drug that is the fifth most-prescribed medicine in the United States. That challenge comes after dozens of patients complained to the People’s Pharmacy — a multimedia source of information about drugs and supplements — of erratic spikes in blood pressure and side effects after they had switched from Toprol XL to a new generic version of the drug.

The fact that generics sometimes differ doesn’t mean that we should drop generics.  But it does suggest that we–and particularly government medical programs and private health insurance plans–should be more judicious in promoting generics.  Saving money ain’t everything when it comes to health care.