Pharmaceutical Drugs Brand Name or Generic - Research Paper Example

 Pharmaceutical Drugs: Brand Name or Generic? Introduction / Abstract The difference between generic and branded pharmaceutical drugs is still heavily debated to this day. On one hand, some argue that since both are basically the same, it would be more practical to buy generic drugs – some of these drugs are even stated to be better (Buffalo News, 2006). On the other hand, some sources, such as Jerod Poore (2003), claim that branded drugs are superior or at least markedly different from their generic counterparts. In fact, examples were cited in which patients reported much better results switching from generic to brand name drugs. Whatever the case, though, generic drugs are undeniably cheaper compared to their branded counterparts – for example, albuterol, the generic name of Ventolin, costs only $0.69 to Ventolin’s $1.44 – making them more accessible to those who are less financially-endowed. Therefore, this article’s aim is to discuss the benefits and practicalities of both classes of drug, and to express a stand on which one is more efficient. Generic drugs According to CareFirst.com (accessed 01/24/10), generic drugs are made out of the same ingredients, and have more or less the same effect as branded drugs – the only difference being the name and the price. Not to mention, it is also worth mentioning that the law mandates laboratory tests to ensure the amount of the drug absorbed into the bloodstream remains constant. Based on just these two facts alone, the quality of generic drugs compared to their brand name counterparts are pretty much given; the site, however, states more details attesting to their quality. For a start, the Food and Drug Administration (FDA) holds both generic and brand name drugs to the same rigorous standards. Specifically, both are tested on their quality, strength, purity, stability, and the delivery of active ingredients. It follows, then, that for generic drugs to exist and be available for purchase at all, they must at least be on the same level as similar, brand name drugs. Since they evidently are (or they wouldn’t be available in the first place), it therefore follows that there is no significant difference in the quality and effectiveness between generic drugs and their branded counterparts – they are just as good, if not better. Couple cheaper costs with that quality, and few could disagree that generics are somewhat of a better choice. This is definitely a good thing, considering how some Americans are barely able to get decent medical care as it is. It’s more or less inevitable that most aspects of medical care are immutably expensive, especially when hospitals are involved. Whether confinement, surgery, or even just a routine physical, that one will spend a little is given; thus, every penny saved helps and goes a long way. And, unlike in other areas, cheaper medicines aren’t necessarily less reliable due to the fact that they need to meet the FDA’s standards. For instance, the following table from CareFirst (accessed 01/24/10), compares prices of various brand name drugs with their generic counterparts: Brand vs. Generic Costs This list represents the most requested prescription drugs and their average costs in 2006. Brand Name Generic Alternative Average Month's Supply Brand Average Cost (Month's Supply) Generic Average Cost (Month's Supply) Cost Difference Allegra FEXOFENADINE HCL 30 $76.96 $61.66 $15.30 Celexa CITALOPRAM HBR 30 $101.21 $31.31 $69.90 Desyrel TRAZODONE HCL 30 $107.27 $6.62 $100.65 Diabeta GLYBURIDE 60 $28.65 $13.83 $14.82 Glucophage METFORMIN HCL 60 $80.47 $21.94 $58.53 Glucophage XR METFORMIN HCL ER 90 $68.44 $43.86 $24.58 Glucotrol GLIPIZIDE 30 $33.36 $23.39 $9.97 Glucotrol XL GLIPIZIDE ER 60 $52.09 $6.73 $45.36 Glucovance GLYBURIDE-METFORMIN HCL 90 $83.60 $62.72 $20.88 Indocin INDOMETHACIN 60 $72.75 $24.71 $48.04 Lodine ETODOLAC 60 $111.55 $53.67 $57.88 Lopid GEMFIBROZIL 60 $99.80 $22.45 $77.35 Lotensin BENAZEPRIL 30 $40.58 $14.05 $26.53 Mevacor LOVASTATIN 30 $102.96 $42.61 $60.35 Monopril FOSINOPRIL SODIUM 30 $50.59 $34.83 $15.76 Motrin IBUPROFEN 90 $42.53 $7.15 $35.38 Naprosyn NAPROXEN 60 $105.78 $13.14 $92.64 Paxil PAROXETINE HCL 30 $110.36 $52.34 $58.02 Prozac FLUOXETINE HCL 30 $218.15 $24.70 $193.45 Relafen NABUMETONE 60 $130.86 $74.93 $55.93 Vasotec ENALAPRIL MALEATE 30 $62.46 $10.79 $51.67 Voltaren DICLOFENAC SODIUM 60 $117.34 $39.79 $77.55 Wellbutrin BUPROPION HCL 60 $111.76 $77.52 $34.24 Zestoretic LISINOPRIL-HCTZ 30 $48.54 $14.25 $ 34.29 Zestril LISINOPRIL 30 $46.23 $10.28 $35.95 As one can see, the price gaps between generic and brand name drugs are very substantial, with some generic drugs costing a lot less than half of their branded counterparts. The most noticeable difference lies between the branded drug Desyrel, and its generic counterpart Trazodone HCL: $107.27 compared to $6.62 - in short, a price difference of over 90%. And since, as stated many times in the previous paragraphs, the standards for generic drugs are no less rigid than the ones brand name drugs are held to, consumers can rest assured that they are not sacrificing quality for affordability. Considering all these facts, it shouldn’t be too surprising that the government has taken notice of generic drugs, as well. As detailed in the Washington Post 8 years ago, then-President Bush proposed new laws in order to promote the proliferation of generic drugs, on the grounds that Americans shouldn’t have to wait long for the prices of prescription drugs to drop. This was a godsend at the time, especially since overall prices for pharmaceutical drugs had been rising by 20% a year. This came as a result of brand name medicine companies exploiting loopholes in order to neutralize competition. At the time, such companies were being given 30-month stays whenever generic companies challenged their patent – a fairly exploitable policy that could be milked repeatedly. But under the law Bush proposed, such stays would only be given once. It would then be up to the FDA to determine whether the generic drug would be fit for public consumption. Another testament to the necessity of generic drugs arose in 2006. As also detailed by the Washington Post, the review of generic drugs by the FDA had slowed to a snail’s pace, due to the many blockbuster drugs going off-patent, and to the rapid proliferation of generic drugs – by then, they already accounted for more than half of all prescriptions. This can be taken to mean that as more and more people came to realize the benefits of generic drugs, the demand for them increased. However, the supply was nowhere near enough to satisfy it. Then-Rep. Henry Waxman lamented such a backlog – more than 800 applications – unacceptable. Kathleen Jager, president of the Generic Pharmaceutical Association, added to this saying that reviews of generic drugs took longer on the whole, despite each individual case not taking long – further proof that there are a lot of drugs waiting to be reviewed. Whereas some people voice worries that generic drugs are less effective than brand name ones (largely due to the massive price difference), Dr. Aaron Kesselheim, as quoted by Amanda Gardner on the Washington Post (2008), stated that there was no evidence to suggest that a significant difference existed in terms of performance. Drs. Melissa Stoppler and Barbara Hecht (2009) clarify such a misconception saying that manufacturers didn’t have to spend money on marketing and developing the drug. When a certain branded drug’s patent expires, these manufacturers are given the option to ask permission from the FDA to sell a generic version – without such a startup cost. In this way, the price reductions are the result of technicalities rather than cost-cutting measures; that is, the manufacturer of the generic drug didn’t tamper or change the drug’s composition (leaving out certain ingredients, for example) to come out with something cheaper. Judging from the previous statements, little doubt can be had that, regardless of what people think, generic drugs are in fact more useful than their price tags would let on. In fact, their cheap price tags would imply that they are more useful than their branded counterparts, if only because the people who need such drugs most will have easier access to them. Brand name drugs Brand name drugs, as already stated above, are the first version of a particular drug to be released to the market. This means that a brand name drug will always come before its generic counterpart. These drugs are definitely NOT cheap, especially when they first come out; some drugs like penicillin (more commonly known as antibiotics) were a novelty at the time they were first created, and as such would only be affordable by the well-to-do. In addition to this, brand name drugs remain without generic counterparts for up to 20 years – so a consumer looking for that kind of medicine wouldn’t have any other choice. Only after such a period has expired can the possibility of a generic equivalent be considered. And even then, it may not be at all – as also detailed above, some companies delay the creation of a generic counterpart to their brand name drugs for as long as they can. Upon further reflection, this researcher speculates that this may contribute to the myth about generic drugs not being good enough. Because the brand name drugs come first, consumers will likely be more familiar and comfortable with them than the generic drugs that are bound to be produced a few years later. This is undoubtedly because the brand name drugs will already have an established track record of effectiveness by the time the generic variants come out – as a result, the latter will only look like cheap knock-offs to consumers who don’t know better, despite being anything but. More tellingly is that some researchers have proven that not all generic drugs work exactly the same as their branded counterparts would. For instance, Nick Holland’s report (1999) compared the drug Ritalin with its generic equivalent, Methylphenidate – both drugs used as therapy for ADD (more commonly known these days as ADHD). This is one of a few exceptions to the rule that generic drugs aren’t too different from the branded ones; In fact, he outright stated his dissatisfaction with Methylphenidate after having alternated between it and Ritalin for two weeks. Side effects observed while taking the generic drug include jittery feelings, talking rapidly – the exact symptoms such medication was intended to suppress in the first place – as well as nausea and other such physical discomfort. At the end of his experiment, he called Methylphenidate ‘nasty stuff’ and relied only on Ritalin as his medication. Holland also notes that, unless doctors specifically write ‘DAW’, meaning ‘dispense as written’, pharmacists will usually interchange brand name drugs with their generic counterparts, and vice-versa. This may be a bit of a problem, especially when the patient concerned is known to have different reactions to the generic and brand name drugs; he may react well to one and badly to the other. In this case, he says, it is important to specifically ask the doctor to write ‘DAW’ on the prescription sheet. Other similar, exceptional cases exist. According to a report by M. Bennett et al of Canada’s McMaster University (2007), pharmacological equivalence and bioequivalence – a state attained when a generic drug’s rate of absorption falls within a certain range of that of the brand name drug – are required for generic drugs to enter the market. To that end, they tested 20 patients suffering from anxiety disorders by secretly switching their medication from Celexa to citalopram (the generic equivalent) and back. Within 8 weeks of the switch, their anxiety symptoms reemerged, along with other equally undesirable side effects. These all faded, however, within 12 weeks of reversion to Celexa. Bennett et al conclude that just as importance as bioequivalence is the individual’s reaction to the generic drug. Not all individuals will react the same way to a generic drug as they do to its brand name counterpart. Judging from the preceding information, it would seem that being made from the exact same ingredients doesn’t guarantee that generic drugs will have the exact same performance as their brand name counterparts. This could possibly be due to the processes involved – regardless of what most of us may think, generic manufacturers and the companies whose brand name drugs these generic drugs were based on will almost certainly have their own, distinct way – their own spin – as to how the drugs are manufactured. This isn’t to say that either is better than the other, but that both will have their own uses – also, that both will have their own share of buyers. Conclusion The debate over generic and brand name drugs rages to this day, and seems unlikely to end anytime soon. Brand name drugs are undeniably effective (they’d have to be, to be fit for use at all), yet are also undeniably expensive. On the other hand, generic drugs are no less expensive but, except in certain situations, are usually just as effective as branded drugs. They are made from the same material, yet different enough for some individuals to have a different reaction to them from everyone else. For the purposes of this research paper, however, this researcher believes that generic drugs more preferable in general. Since they are usually just as effective as brand name drugs, yet are not in the same price range, it stands to reason that most money-minded patients would get them instead. More importantly, though, one must know which one – the brand name or the generic drug – to get, and when. There’s no point in saving some money when one compromises his own health to do so. References Brand vs. generic costs (accessed 01/24/10) Retrieved 01/24/10 from https://www.carefirst.com/pharmacy/GenericDrugs/BrandvsGeneric.html FDA slow to review generics (2006) The Washington Post, p. B11 Gardner, A. (2008) Generic heart drugs as good as brand-name counterparts, The Washington Post, Retrieved 01/24/10 from http://www.washingtonpost.com/wp-dyn/content/article/2008/12/02/AR2008120202303.html Generics give vital savings ; Western New Yorkers best at embracing less-costly versions of name brands (2006) Buffalo News, p. H4 Goldstein, A. (2002) Bush plans new rules on generic medicine, The Washington Post, p. A01 Holland, N. (1999) Methylphenidate vs. Ritalin, Retrieved 01/24/10 from http://www.nickh.org/add/addopin4.html Poore, J. (2003) Brand name vs. generic drugs – the differences are real, the studies prove it, Retrieved 01/24/10 from CrazyMeds, http://www.crazymeds.us/BvsG.html Stoppler, M. & Hecht, B.K., M.D. (accessed 01/24/10) Retrieved 01/24/10 from MedicineNet.com http://www.medicinenet.com/script/main/art.asp?articlekey=46204 Van Ameringen, M., Mancini, C., Patterson, B. & Bennett, M. (2007) Symptom relapse following switch from Celexa to generic citalopram – an anxiety disorders case series, Retrieved 01/24/10 from PubMed.gov http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17664246&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum Why brand name drugs are expensive – facts about generics (accessed 01/24/10) Retrieved 01/24/10 from https://www.carefirst.com/pharmacy/GenericDrugs/FactsAboutGenerics.html Why brand name drugs are expensive (accessed 01/24/10) Retrieved 01/24/10 from https://www.carefirst.com/pharmacy/GenericDrugs/DrugsExpensive.html Read More