What's your take on the WalMart prescriptions

[Doc_Bob]

Generics have there place I agree, but thet do not undergo the same degree of testing as the original.

If you read this far I thank you for your time.

Phil

I agree with you completely. Even more imporanttly, folks should learn from all of this the tremendous amount of work the Pharmacy Industry does in creating and testing new medications. Anyone who thinks it is easy has no idea what they are talking about. The "drug" industry earns and deserves every penny they make. Without them many folks would be dead. Good work costs $$$$$$$$$. I wish more folks would learn that simple fact before they complain about the cost of medications.
Bob

 

[IrTxRx]

Tractors Smactors... now this is my kind of stuff!!!

Phil -- Generics do undergo the same amount of testing as the brand name drugs... It was done previously by the brand name company!!! The chemicals do not care who did the studies. For all that hard work, the brand company reiceved 17 years of exclusive rights to market that medication. If it is quick to market, they get a decade or so... If not, maybe a few months. (However, in reality, most brand manufacturers can extend this window significantly with legal maneuvers and clinically irrelevent formulation changes).

Excipients (sometimes incorrectly called inactive ingredients) can be different.

Excipients can have dramatic/profound/unbelievable effects on the characteristic of what a drug containing product does in the body -- but the studies that the generic companies have to conduct show that in the body, where the drug matters, it is the same. You swallow a brand pill or you swallow a generic pill, the active ingredient is in your system at the same time, peaks at the same time and lasts the same time.

Doc Bob --
Regarding drug companies -- they have enormous investments so I am ok with enormous gains/profits. What I am not OK with is that more is spent on marketing/lobbying than is spent on development. Most studies quote a difference of 3:1. Studies have shown that prescribing habits ARE influenced by the short skirts and fancy dinners that we are exposed to while at drug company "educational" events. I've been hosted by drug companies too, it affects your thinking. Who gets stuck with the tab... the patient who doesn't know that a dirt cheap alternative is available.

MikePa -- "Why is having it a loss leader bad?" --
Annually, medication errors have been estimated to cause more deaths than breast cancer and highway accidents combined. Direct costs of medication errors are estimated to be 3.5 billion annualy. Cost of preventable adverse drug events has been conservateivly estimated to be $90 billion... BILLION!!!
By comparison, all diabetes care costs 48 billion, annually. I don't think the pharmacy is the best place to be working on a shoestring budget. I caught 3 medication errors today... It is unlikely that any one of them would have resulted in significant harm... but eventually, one will. As a revenue losing department it is hard to battle for resources.


If you read this far... Wow and thanks

 

[MikePA]

I don't think the pharmacy is the best place to be working on a shoestring budget...As a revenue losing department it is hard to battle for resources.

So, from $4 prescriptions, we leap to the conclusion the Walmart pharmacy will be underfunded and from there we hurdle to the conclusion that prescription errors (adverse drug interactions) are sure to follow. I guess there is a cloud around every silver lining.

 

[PhilNH5]

Phil -- Generics do undergo the same amount of testing as the brand name drugs... It was done previously by the brand name company!!! The chemicals do not care who did the studies. For all that hard work, the brand company reiceved 17 years of exclusive rights to market that medication. If it is quick to market, they get a decade or so... If not, maybe a few months. (However, in reality, most brand manufacturers can extend this window significantly with legal maneuvers and clinically irrelevent formulation changes).

Excipients (sometimes incorrectly called inactive ingredients) can be different.

Excipients can have dramatic/profound/unbelievable effects on the characteristic of what a drug containing product does in the body -- but the studies that the generic companies have to conduct show that in the body, where the drug matters, it is the same. You swallow a brand pill or you swallow a generic pill, the active ingredient is in your system at the same time, peaks at the same time and lasts the same time.

IrTxRx,
I don't really have a leg to stand on. Our regulatory agency allows BE studies as the test to bring generics to market. They write the rules and we have to play by them. But I stand by my statement that the generic manufacturers do not do the testing the patent holder did.


Synthetic pathway and excipients are two topics I brought up. These are well characterized and well tested prior to the patent holder going to market. But not at all by the generic. I would hope they identify and characterize any impurities, check for isomers or racemates and any other testing to prove the active pharmacology ingredient is the same as our API.

I run a PK lab so I know well the concepts of Cmax and half life you allude to. BE studies address this. But that is all they address.

But as I said at the beginning of this post. I am on the losing side of this argument. The FDA accepts BE studies.

Phil