# Generic Drugs



## fraser (May 15, 2010)

We don't take many prescriptions, in fact the only one is for DW.

So, we went to Costco Pharmacy to get it renewed. The Pharmacist looked at the renewal and told us that there was now a generic available-exactly the same- and did we want it. Yes of course we did. The price went down from $1.13 per pill to .36 per pill. Very convenient since we had just emptied our HSA entitlement and had to pay this ourselves.

We were very pleased that the pharmacist mentioned this to us as I suspect that they make higher margins on the name brands.


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## Cal (Jun 17, 2009)

Generally this will be the case until the drug patent expires.


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## Toronto.gal (Jan 8, 2010)

Generics will become more profitable than brand name drugs as the latter, as Cal mentioned, lose patent protection. Recent examples:

http://online.wsj.com/article/SB10001424052970204652904577194601449596184.html

I personally would not have switched drugs without first asking my doctor. And btw, it's typical for pharmacists to pose that question, so I wouldn't give them any credits for that.


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## fraser (May 15, 2010)

DW has a medical background. The generic has the exact composition of the patent. No issue. Had it not, we would definately had consulted the physician.


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## Young&Ambitious (Aug 11, 2010)

I actually have always gone for the generic brand _until _I spoke with the bf's brother who is in this business on the science side. He was saying that he could not believe the non-quality or low-quality crap that goes into the cheaper drugs in order to allow them to be cheap and advised not to buy no-name or low price necessarily.

Cautionary takeaways: 
a. Price = quality; and
b. Copycats may not mimic 100% the patented version.


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## andrewf (Mar 1, 2010)

^ That's hard to believe. 

Price != quality-- at least not necessarily. You're paying for marketing and development costs with name brand drugs--who is to say there is any difference in marginal production cost of the drug itself.

The recent change in regulations in Ontario have changed the incentives quite a bit for pharmacies. They used to earn a significant part of the operating income from what were essentially kickbacks from drug companies. I personally think that drugs should flow through pharmacies at manufacturer cost, and the cost of running the pharmacy paid out of dispensing fees.


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## Toronto.gal (Jan 8, 2010)

Here are some 'facts':

http://www.fda.gov/drugs/resourcesf...afely/understandinggenericdrugs/ucm167991.htm


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## andrewf (Mar 1, 2010)

Thanks, T.gal. Good find.


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## MoneyGal (Apr 24, 2009)

Canadian version on the same topic (i.e., bioequivalence):

http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/med-gen-eng.php


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## MoneyGal (Apr 24, 2009)

I took an *entire class* in grad school on generic drug policy and manufacturing patents (in the context of Canadian manufacturing and public policy). It was really, really eye-opening.


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## Young&Ambitious (Aug 11, 2010)

The guy I talked to is the one making those generic drugs and if he wouldn't use it, then I'd side with him. Just my opinion and to each their own. Some things I don't mess around with and what I put into my body certainly makes the list.


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## Toronto.gal (Jan 8, 2010)

Imagine the cost of health-care, insurance plans, etc., if there were no generic substitutions for any drugs, which are much lower than brand name ones.

Affordable & effective pharmaceuticals for all is the key issue.


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## Islenska (May 4, 2011)

As a semi-retired pharmacist in Manitoba we must sub generics for brand name by law. The patient can pay the difference for brand name but few patients end up doing this.
There is very little mark-up on the drug itself, your profit is the dispensing fee. Generic rebates are really reduced but only enabled the decline of Mom and Pop stores, Shopper's will benefit down the line as their market share is enhanced.
The debate of generic vs brand name is complicated. Personally a good example is the quality of Amoxil liquid for kids. The real stuff is far superior as a mixture but generic is supposedly bio equivalent but is open for debate.
Generics spawned a huge internet pharmacy industry (much out of Manitoba) but big Pharma(USA) and government regulators have put the crimp on things. Important to note that new drugs and specialized ones like insulin, some heart, chemo drugs etc... have no generic equivalent being too difficult and expensive to copy, No easy answer...


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## Toronto.gal (Jan 8, 2010)

Islenska said:


> Important to note that new drugs and specialized ones like insulin, some heart, chemo drugs etc... have no generic equivalent being too difficult and expensive to copy, No easy answer...


Indeed there are many drugs with no generic equivalent, and one of the reasons is because some are complex biologic drugs [antibodies, interleukins & vaccines], which means that the manufacturing process is very different from other prescription drugs, but no doubt it's only a matter of time before the 'biosimilar' alternatives become available, especially with the expiration of many patents in the future.
http://en.wikipedia.org/wiki/Biologic_medical_product

In chart below, we can see that there are no shortage of generics for heart drugs for example:
http://www.health.harvard.edu/newsl...ry/Generic_heart_drugs_as_good_as_brand_names

From my last reading, I believe there are about 3 dozen generic cancer drugs on the market atm [US], but some generics are in short supply due to lack of profitability [some costing 100x less than the brand names].

This topic has reminded me of the movie 'The Constant Gardener' & 'Contagion'. 

A complex issue for sure.


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## Toronto.gal (Jan 8, 2010)

*It’s generic drugs or nothing, Canadian insurers say*

The changes — from Sun Life and Great West Life — come amid a new battle between pharmaceutical industries, as billions of dollars worth of brand-name drugs go off patent, opening the market to far-cheaper generic copies. Between 2010 and 2014, patent-protection will have ended for prescription drugs worth an estimated $7-billion a year in Canada, according to one estimate.

http://news.nationalpost.com/2012/09/10/its-generic-drugs-or-nothing-canadian-insurers-say/


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## Navigate Sensibly (Oct 24, 2011)

Yes, which could mean that in the future, insurance companies will determine whether you get brand or generic simply because some people will not be able to afford the brand name. I am not saying whether one is better than the other brand, but rather that patients with financial difficulty will only be able to afford the generic, even if they prefer the brand. 

Perhaps when interest rates go up, insurance companies will re-think this strategy


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## andrewf (Mar 1, 2010)

I see no problem with insurers only covering the cost of generics, if available.


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## Navigate Sensibly (Oct 24, 2011)

andrewf said:


> I see no problem with insurers only covering the cost of generics, if available.


Yes, you mean no problem for the insureres. For some patients, it probably does, unless you can convince them otherwise.


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## andrewf (Mar 1, 2010)

If people want to pay for brand, they should pay out of pocket.


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## Tom Dl (Feb 15, 2011)

I am on this blood pressure drug, and it was available as a generic when I first bought it, then after a few months the generic disappeared, and I now have to pay out of pocket for the brand name. The price increase is significant. The generic was initially supplied by a mom and pop drug store that is excellent, and later by Shoppers. Then it dropped rom sight. Is that a common thing with generics?


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## andrewf (Mar 1, 2010)

Have you tried complaining to your insurance?


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