Generic vs branded drugs

PreetPari

@PreetPari

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Posted: 13 years ago

#1

Originally posted by: curious1
while a family member of min was watching the show I happened to catch last 15 minutes of the show where they were bashing the branded drugs.
Oh My God how unintelligibly spoken. Even if some of it was true the way it was presented was not the whole truth.

The doctor said that the difference between Generic drugs and Branded drugs is incomparable. yes it is very true but did they make an effort to explain why?
The branded drug companies are the ones who actually do the research and bare the full cost of getting it to the people which also includes FDA approvals. Any clinical trial could cost millions of dollars. sometimes they succeed and more often than not they fail due something lacking according to FDA. I do not know if it is ok for branded drugs to charge a whole lot more or not but there is a very good reason why. This reason is very similar to how most of you have defended Aamir Khan saying that he needs to cover the cost and the time he is spending. The logic is the same for pharma companies. They need to cover the cost and save up enough to do more research. A lot of pharma companies also have foundations where they make these drugs available to poor people if they are eligible.

Bottom line is that if nobody is running charity and if Aamir's money is justified then why not the pharma companies who are so dedicated to find cure.

Generic companies are able to give a lower price because they only copy the formula and manufacture it. they ave zero research cost so obviously they will be able to sell it for cheaper. It is not to say that their profits could be much more than the pharma who launched the drug.

The analogy of Ramu ki bhains was totally ridiculous. There could be genuine differences between milk of Ramu ki bhains and any other bhains as Ramy may be feeding the bhains better stuff and other bhains could be fed differently and be on growth hormones dangerous for consumers.

I agree that everyone deserves access to drugs and nobody should ever die due to the lack of it but is bashing pharma companies the solution for it? By doing so are we not unappreciative of the efforts they are making the life saving drugs.

I am reading other threads and see that the show is on its decline anyway.
For me that fifteen minutes confirmed that mu decision of avoiding the show was right.

Above was mentioned in a thread, i thought it will be nice to have a separate discussion on this.

Edited by PreetPari - 13 years ago

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PreetPari

@PreetPari

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Posted: 13 years ago

#2

So i did some reading on this topic. Companies patent anything they discover and only they have the right to produce and sell the drug they invented. When the patent expires, the other manufacturers can also produce same drug. Before the patent expires only that original brand name makes all the profit so they get the advantage for inventing the drug and all the expenditure. So the generic drugs are made only after main company have already made profit during the patent period.

Wikipedia article on generic drugs have great info about all aspects including economics.

Edited by PreetPari - 13 years ago

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blokes

@blokes

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Posted: 13 years ago

#3

preetpari- another hidden cost is the crores spent on "marketing the drugs to docs and offering them "gifts" and bonuses. This sick american tradition has taken root in india and has destroyed the entire medical system of sincere committed medical professionals.

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PreetPari

@PreetPari

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Posted: 13 years ago

#4

Originally posted by: blokes
preetpari- another hidden cost is the crores spent on "marketing the drugs to docs and offering them "gifts" and bonuses. This sick american tradition has taken root in india and has destroyed the entire medical system of sincere committed medical professionals.

Very true, this whole system of commissions is at every level, not only for drug but also recommending a specialist, lab tests etc. Poor people end up not getting any treatment as all these malpractices make the cost of services out of their reach. 😔 This aspect was discussed in episode 4. I mean the bonuses to docs by drug companies was discussed not the influence of US tradition, that is whole new topic. I am not sure about drugs but i know US bans some chemical (e.g. pesticides) sales in US but dont ban the production of those chemicals so the companies can still produce and sell those banned chemicals in foreign countries😲

Seriously if they know that something is dangerous to people then why not ban the production of that stuff. Maybe they consider all non-americans are another species!! perhaps more resistent to toxic chemicals than americans!

Edited by PreetPari - 13 years ago

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Nach_Baliye

@Nach_Baliye

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Posted: 13 years ago

#5

I didn't like this episode at all, because it focused on just one aspect of drugs. Pharma companies spend years on research & development and need to recover the expense before the patent expires. The guy who came on the show made it seem as if brands are doing something bad by pricing their drugs higher when generics are available. Who knows how reliable the generics are? If a doctor has been prescribing a branded drug for years when the patent is in effect, obviously the doctor will continue to prescribe it rather than test something new without knowing whether it would have the same impact.

As for marketing, every single thing is marketed. Companies spend a lot of money on marketing every single product. Pharma companies have to spend on marketing to increase awareness about the drug and "disease". They have to give samples. They have to educate people.

When Viagra was launched, there was a call center dedicated to questions from men since it was a "taboo" discussion. The toll-free number was promoted in TV advertising.

In every ad, pharma companies have to include side effects and other information by law. Branded vs. generic drugs discussion has to be explored and researched thoroughly before jumping to conclusions and presenting it as "bad" on national TV in a 15-20 mins segment.

I was reading research about psychiatrists in the US, they are the most "pampered" segment of the doctors population since they are taken on trips by pharma companies. This causes them to over-prescribe, and in some situations they prescribe to teenagers and heavy drugs may have the opposite effect.

All of this needs to be its own episode. The last person who - the Belgium guy - was a colorful character, he came there more to add color and entertain rather than speak facts. Healthcare system in the US is very very poor, Europe's culture of providing freebies to its people is the cause of its debts, the Belgium guy was mis-informed. I was disappointed with the half-truths this episode touched upon. Aamir should have stuck with unnecessary surgeries and made generics vs. brand a separate well-researched episode.

Edited by Nach_Baliye - 13 years ago

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dharad

@dharad

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Posted: 13 years ago

#6

PreetPari,

Good thinking. I work for a fortune 500 Pharma company. My company makes and sells both branded and generic (mostly our own brand) drugs. I am working at the manufacturing site in QA. I have seen the entire life cycle of a drug and how much it takes and costs. While the big pharma, spends on the drug from innovation to market, the generic only has to get the patent once it expires and make the drug. The biggest hurdle is clinical trials and FDA approval. The time and money spent here is enormous. Added to this is the patent life, FDA only allows 8 to 10 years on a patent. The big Pharma has to cover their costs and make the most profit during this period.

Said that, another thing is like not all generic medicines are replacable. my husband and I take both brand and generic meds. I was on Glucophae, my chemist switched me to Metphormine per the insurance policies. I had serious issues due to this switch, my stomach bloated, I had hyper acidity and other side effects, also my sugar was not controlled as well. My doctor had to switch me back to brand name.

The biggest beneficiary here is the insurance companies. They are the ones who benefits the most. In the US the Healthcare Insurance companies have standing instructions to the chemists on all drugs, they must dispense the availble generic for any brand name prescribed unless instructed by the doctor to use brand only. And most doctors are not happy prescribing brand names as they have to justify the brand which means extra paper work. We have to fight with our pahrmacy each time we order the prescription. Although you pay almost the same co-pay for the brand or generic medicine. Its not so easy to remain on brand name.

I do not disagree that for those who cannot afford brand, a generic substitute should be available. But that depends upon the doctor who is well aware of all the options. At the same time brands should be available for those who are not happy with the generic. The top mot company making highest dollar value in the US is currently a generic - Teva. So to say that genrics are acheap and the company do not make as much money is not true. FDA is much more lax on generics compared to big pharma. Some of the smaller generic companies do not even have written procedures for their products, FDA willnot raid them unless a serious complaint is lodged as the big money is with big Pharma. The price paid for maintaining the licence is very steep. Every tow years FDA is at your door step. Every little offense per FDA ( you may be doing the best pr the available regulatory requirements) costs millions of dollars.

All or most Big Pharma companies contributes to the WHO programs, they provide free or minimum fare meds to the countries and communities that cannot afford medicines at their market price. If you go to the official site of any company all these information is right there and most doctors are aware of such information.

I do agree that big companies do get greedy and want to keep the biggest of market share and will try to do their best to monopolise the market. What the NGos and other such groups need to do is to find the right resouces and make sure to make good of all the programs offered.

Lastly I would not blast Aamir for anything as he is trying to bring out issues and making the people aware of the ills of our society. I would salute him for what he is doing, more strength to him and his like.

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PreetPari

@PreetPari

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Posted: 13 years ago

#7

@ dharad well said and thanks for sharing your experiences in US. I hope someone shares their first hand experience in India too.

I personally have suffered from somewhat similar situation. I was recommended a pill and at pharmacy was given generic. The active ingredient is same but inactive ingradients or fillers, something was different so it dint suit me.

But i think the emphasis in SMJ was to at least meet very basic medical needs for common ailments for poor people. At least people shouldnt die because of easily curable ailments. No doubt they gave examples of some costly medicines for cancer etc too but i think overall goal of that small section on drugs during this episode was to highlight that even after so many years of independence large proportion of population do not have access to affordable medicine for common health problems and making generic drugs available these people can really make a big difference.

I think we should keep giving feedback along with supporting the current efforts (like you did dharad, i liked your concluding remark)

Who knows SMJ is just starting point and will open door to all kind of detailed discussions on different small aspects of each episode.

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PreetPari

@PreetPari

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Posted: 13 years ago

#8

Originally posted by: Nach_Baliye
Aamir should have stuck with unnecessary surgeries and made generics vs. brand a separate well-researched episode.

Thats right, i am hoping after learning that people do want to listen to them and people are watching the show and interested in even more in depth discussion on various issues mentioned, they might plan to go into details of various aspects of each episode in future.

We also need to consider that they are addressing a wide range of audience with those who dont even know what generic means on one end and people like us on the other end who are interested in well researched, detailed discussion of each aspect of the main topic.

As i have said before, i think the main goal for that small section on drugs in this episode was that by making generic medicine available, we can at least make sure that poor people wont die because of inability to buy medicine for even very common ailments. So great first step at least 😊

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-scarlett-

@-scarlett-

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Posted: 13 years ago

#9

I don't get why we are having such a big discussion about the drugs. I don't find anything wrong with Generic drugs, and it is true that for the common man in India, branded drugs are very costly. And for the point made above, FDA DOES research the generic drugs, all the procedures are to be followed whether the drug is branded or not. Also, I know for a fact that companies spend millions on marketing and packaging the product while the product itself costs much less. Now, blaming those companies for having good packaging and marketing is not wrong, but having bribing the doctors is wrong. Also, the generic drugs were mentioned as a solution for a common man who wants the basic medicine. If the other people, with money, want to stick to the branded...then no one is stopping them. I felt that its good that the team went into drugs, because that's also a big part.

Edited by -Vishwa- - 13 years ago

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curious1

@curious1

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Posted: 13 years ago

#10

The original comment was mine and I see a new thread created so I thought would contribute.

In America there are strict spending rules for the sales reps. Pharma companies are required to provide the aggregate spend for any physician. They are not allowed to bribe the physicians and there is a max (varies by states) on how much money can be spent on a physician by any salesroom from that company. There are more acts s(sunshine act etc) solidifying this more. No sales rep are allowed to discuss any off label usage of the drug and the on label usage is published by FDA.

In a nutshell yes sales reps are commission based and have an interest in selling their drugs but the doctors have no insinuative for being biased. Consequences in US are very serious if any physician, sales rep or pharma company can be proved of giving or taking bribes.

I am in US for 20 years but would like to hear experiences in India around this.

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