Are Generics Just as Good?
The FDA says they are. Lots of patients say otherwise. Here's a Wall Street Journal article about a generic that releases 34% of the drug in the first two hours compared to 8% for the brand name drug. Four times the impact is apparently too much for some patients and there have been lots of complaints. Bottomline: people shouldn't be forced to choose one over the other. But patients should pay the full costs and reap the full financial benefits of the choices they make.
The Wall Street Journal has published two Letters to the Editor in response to this topic.
See here.
In cases where drugs have a narrow therapeutic index, generic substitution has been a problem for some time. Participants at a 2001 American Society of Transplantation conference were so concerned about the effects of forced switching from brand to generic immunosuppressive drugs that they called for patients to be educated to inform their physicians of any switch to or among generic alternatives.
Other cases in which compulsory generic substitution clearly causes problems include epilepsy and tacharrhythmia. Finally, it turns out that a lot of people have no idea how much variation there can be in a generic that meets FDA requirements. Biologics pose a much more difficult problem.
Like so many things in health care, the wisdom of compulsory generic substitution isn’t as simple as those pounding the table about waste in medicine would have one believe.