Today Show just did a piece about generic drugs.

[ejpoeta]

In the piece they showed a woman who was on medicine for seizures, i believe. the pharmacy switched her meds to generic without her knowledge and a month later she had a seizure. I guess generics can be between 80% and 125% of the ingredient in it. This I did not know. And I guess the meds can even be changed between different generics for a drug without telling the patient. And the doctor has to specifically say dispense as written, which I already knew.

Now, a couple of things about this story. I question the messengers here, because I have become cynical and wonder if the media isn't trying to scare people out of buying generic forms of medicine. Or should we really be concerned with the reliability of our medicines, those of us who have to pay high copays if we DON'T get generics?

The woman in the story ended up back on her original brand name medicine. I believe she had said it was rather pricey, but her copay is only $4.... I know she must have a great health insurance plan if her copay is so low. When we had my daughter on Ritalin time release when we had independent health, our copay for that was $40/mo. We couldn't afford that, so she went back to the regular one that we could get a generic for. And we can tell the difference, because now that she is on Child health plus, there is no copay so we put her back on the time release and the difference is amazing.

So I wonder, a health care system where some who have insurance that has such low copays even on a pricey drug while the rest of us have to deal with the possibility of a generic drug that is not good enough. As well as a system where a pharmacy can overrule a doctor's prescription and give a person generic without even telling someone. If the generics are so varied in strength, can't the FDA regulate them so they are not so varied? And can't we have a system where everyone has access to the same reliability in medicines?

[madokie]

1. I take pain meds and sometimes I can tell a difference in strength

from one month to the next. Hell a few months back they were so much better that I squirreled about a third of them away for hard times like when they don't arrive in the mail on time

[ejpoeta]

2. that is just ... wrong. i have been on a generic depression medicine

which i am not taking right now because i am pregnant.... but that explains a lot, actually. generics should have to be more specific in the ingredients! this is ridiculous.

[madokie]

5. sure it is but I use the VA for my healthcare

and I'm not even sure if I have a say in generics or not. Some months they are from one manufacturer and the next from another. In all they, the VA, use pills from three different companies to fill my prescription with.

[MercutioATC]

3. Like everything else, don't panic OR dismiss it out of hand...just be aware.

Generic equivalents work just fine in most cases, but they're often NOT identical.

If you have concerns about a specific prescription, ask your doctor or pharmacist.

[AspenRose]

4. I could definitely tell a difference between my generic and name brand drugs

even though my doctor said there was no difference. I requested he write "dispense as written/brand name only" on my prescriptions.

So now I'm paying out the wazoo for brand-name drugs. :mad: Thank God we have the money and the insurance to do so. Lots of folks don't.

[hedgehog]

8. My impression is that the laws regulating generics are too general.

I don't have the numbers at hand, but I think instead of saying the pills must be dose accurate plus or minus 3%, the rules say something like the pill must be dose accurate say plus or minus 3 milligrams. That's fine when the dose is 100 milligrams, not so good when the dose is 0.03 milligrams.

The other complication is that while the active ingredient may be the same, the carrier may be different. If the coating dissolves in the stomach instead of the intestines,maybe the ingredient is destroyed by stomach acid. Or maybe the dose is absorbed as a slug instead of gradually over 12 hours.


Some generics are fine, others not so much.

[elleng]

6. Surprising 'facts' here.

We should inform Prez O, his health care people, and our congresscritters.

[azul]

7. Trashing generics benefits big pharma rip-offs.

Many states and insurances require generic substitution, by law or contract, but brand name can be dispensed if patient or doctor requests it. Then, many insurances require the doctor to call them to explain the medical necessity to do so for authorization.

The manufacturing standards are the same for brand and generic and have the same allowance for variation in manufacture. Most of the generic companies are now owned by large drug companies and many generics drugs are manufactured by the brand name factory and re-marked as generics.

Drug companies that have poor manufacturing standards usually would show up by FDA testing and be recalled or prevented from release. Drug wholesalers are the step that should weed out most problem companies in the distribution chain. However, the FDA could use more funding and staff to improve the enormous regulatory challenge to insure safety. IMHO.

[WeDidIt]

9. That's disturbing

Especially since once a generic is released, my co-payment for a name brand goes up so I switch to generic.

[havocmom]

10. Name brand drug worked well for me. Generic landed me in hospital

Once a generic version came out, the insurers let bookkeepers decide my medical care and they looked like Wile E. Coyote on a really bad day before it was all over. Four doctors at the hospital said the substituted generic had been shown to trigger heart attacks in many people. I was lucky that: A) I knew the signs & chewed aspirin just before hitting the floor while telling daughter "get me to hospital NOW" and B) the hospital was really really close and not real busy that day.

Insurance Company STILL had to be hammered by the pro-patient doctor I had at the time. Rat fuckers' demand that I get a cheaper version damn near cost me my life. It defiantly cost insurer more than the original prescription would have cost them.

Fact: We have had RATIONED CARE for years in America.
Fact: Big Insurance is fine with Rationed Care, so long as they (and the physicians they put on payroll as their legal beards) get to do the rationing.

And to be fair, Big Pharma sometimes wants to scare the crap outta us so we keep paying them off. Lots of generics work fine for lots of people. Sometimes both Big Pharma and Big Insurance will be at war. You can bet we will be the collateral damage no matter who wins any given battle.

Fact: Better regulation and enforcement is needed for insurers and drug manufacturers. It scares the crap outta me that I do not know the country of origin for some of the meds I take now. I know manufacturers moving to China and other places do so due to lax regulation and oversight for many products. And I know employees at agencies charged with regulation/enforcement for many products are too few and far between.

Medical care in America fell victim to capitalism years ago. I understand that. But I am still not willing to accept that status quo.

[Patiod]

11. Good reply -- this is NOT a clear "good guys/bad guys" issue

I work in pharma, and know that, as people have noted above, very often, generics work just fine. But sometimes, when precision matters, they may not.

Pharma DOES indeed want to scare people off generics so folks always demand the brand name. On the other side, insurance companies would like you to think generic is ALWAYS the right choice. Talk to your doctor, but realize that he or she may be getting their info from the drug companies. Do some research, if you're able.

What might help is tighter regulation of amount and quality of ingredients before the Chinese start dumping adulterated crap into our meds (yeah, slightly OT) An acquaintance was about to rep for a Chinese chemical company (and be paid well for it) until his company tested the Chinese product and found out how bad it was. They turned down a lot of money when they opted not to rep for this company, but would everyone make the same decision?

[havocmom]

15. The China Connection is sorta OT, but also part of the equation

Bravo to your friend for turning down the job shilling for pills of poor quality. Sadly, your question about whether everyone else would make that decision is a valid one.

The real problem is NOT China, nor insurance companies, nor pharma companies. The REAL problem is the business model that puts profit above all else, and the cultural trend to go along with that flow, that only money matters.

Greed is the real bitter pill.

[ejpoeta]

14. that's why i laugh at that whole bs crap about why we shouldn't have

"socialized medicine". we don't want someone making those choices and decisions for us!!! they ALREADY DO!!! why do people not friggin see it! grr!

[havocmom]

16. Yep. Rationed care is what we get, with insurers' bookkeepers doing the rationing

It is amazing how people let the insurers bamboozle them with fear mongering crap.

[ejpoeta]

17. and it's not just that it is rationed or controlled by the insurance companies.

it's that they have a profit motive for their decisions. everything they do is with the intent of increasing their profits. that is why a for profit system is the worst system we could have. instead of health being the motive, it is money. and we can never win in that scenario.

[havocmom]

18. And they take our payments to play the stock market. When that is down, they want more $

and they will do anything, cut any corner to get it.

For-profit is NOT for people and you can't have health care without being for people. Current system is just a well disguised money funnel to the same ol institutions/class.

[uppityperson]

25. Name brand drug (synthroid) almost landed me in the hospital

After a month on Synthroid brand, I was severely hypothyroid to the point I almost ended up in hospital. Doc told pharmacy to give me a generic brand and I was better, up and going, in a few days.

Got on natural thyroid later and am doing much better. I have found no difference between name brand Armour and generic.

[vanlassie]

12. I think they put Nancy Snyderman into some sort of contract

to yammer daily about something- anything- that supports the interest of big business. Lately she is a constant annoying presence.

[blueworld]

13. Generics are NOT identical, they're similar

I worked with & for Big Pharma for almost 15 years. With insurance companies for almost as long. I've posted about this before, so my apologies to those who've seen it. The FDA has a database of at least 125 acceptable "fillers"; generic drug makers can use any of them any time. The main ingredient is supposed to be identical & manufactured according to an identical process, but in fact - it often isn't. The insurance companies force us to use generics. Rural areas like mine order different generics every bloody month. One month my meds are pink, next month green - how the heck am I supposed to know I'm getting the right thing in the correct dosage? I can't. The different generics interact differently with my other drugs.

If I have high blood pressure, what if my new "filler" is salt? If I'm diabetic, what if my new filler is "sugar". I've read scores of reports about allergic reactions when a generic is switched because of the "inactive" ingredients.

If my body adjusts differently to the generic, my dosage may have to be adjusted. If my body can't get into a steady rhythym, will the meds actually work & lower my blood pressure. Even my doctor says "no".

Drug makers buy up the generic companies so they're cleaning up on all ends. The US companies are owned by French & German & Norwegian companies. Ingredients can be "sold" by a parent company to their US company. The "parent" company might be importing components from China. The FDA doesn't care because "US companies don't import drugs from China".

Jeebers-jumpin' crispus in a sidecar. They tell us if we can work, where we have to live to get a job, what diseases we'll get from their pollution & work methods, how much insurance we'll get if any, what treatments are "acceptable", which drugs we can have

And they're poisoning us in the bargain. Are we ready for a revolution yet????? :rant:

[ncrainbowgrrl]

19. Wish I could recommend a specific post in a thread.

I take pain meds, and can DEFINITELY tell the difference in brands. Luckily, I'm fortunate enough to be able to go to different pharmacies when they don't carry the brand that works, but... if i were in a more rural community, it wouldn't be an option. I also use ritalin, and the generic is ridiculously NOT the same. the Plus or minus can make the difference between having my heart race, or not getting intellectually and physically able to combat the woes of the day.

[havocmom]

20. Second that!

One wonders about those mail out Rx refills the insurers are so fond of. Not just rural populations who have limited options. If your policy requires use of mail order refills for things you take all the time, what guarantee do you have about formula & quality?

[BrklynLiberal]

24. Ditto!

[Liberal In Texas]

21. Generics SHOULD be identical, not similar, and it should be law.

Otherwise it should be sold under another name as a different drug, and not be labeled as a generic of X.

I got switched to a generic of a HBP drug almost 20 years ago when the patent ran out. My BP went up and when the doc wrote "as written" and I started taking the name brand again my BP went to normal. Even now, I have to fight the insurance company and their Rx vendor to keep them from refilling with a generic. Even when the Rx says "dispense as written" if you don't check a certain box on their form, they'll send a generic every time.

[TZ]

22. FYI--anything manufactured in another country has to meet the same regs

as stuff sold in this country so a generic made overseas SHOULD be the same as the ones made here. The problem is the FDA is stretched too thin and does not have the personnel or money to inspect as many of these manufacturers as they should. Most of the companies that manufacture overseas are honest and upright..its the snakes that give many companies bad names

[BrklynLiberal]

23. We are all victims of Big Pharma..one way or another....

x(

[ejpoeta]

26. i'd say big pharma AND the insurance companies. getting it both ways.

[BrklynLiberal]

27. You are 100% correct....