Are You Paying for Cheap Generic Medication with your Life?

generic medicationBranded drugs and the generic equivalents contain the same active ingredient and therefore should theoretically have an identical therapeutic action and desired effect for the patient taking it. However, this doesn’t change the fact that there are a growing number of NHS patients quite adamant that the branded version has a) seemingly worked better for them and also commonly b) given them less or indeed no side effects compared to the generic medication.

There are certain branded medicines that GPs either cannot, or will not prescribe anymore. Weight loss treatment Xenical is one example, male impotence drug Viagra another, as well as cholesterol-lowering statin drug Lipitor.

Instead, patients may see the generic name ‘Orlistat’ instead of Xenical, ‘Sildenafil’ instead of Viagra and ‘Atorvastatin’ instead of Lipitor. These are all generic medicines, in other words, you will be getting a much cheaper alternative produced by a different manufacturer to the more expensive branded version.

At Medical Specialists® we hear from many asthma patients who are requesting the blue asthma reliever inhaler Ventolin Evohaler because they only receive a generic Salbutamol inhaler through the NHS, and it isn’t guaranteed to be Ventolin they will receive. A lot of patients are claiming that the Ventolin inhaler relieves their asthma symptoms more effectively than other Salbutamol generic alternatives.

It is easy to see though where the benefit lies with more patients being prescribed generic medicines. Each year almost three quarters of prescriptions in England and Wales fulfilled by the use of generic products, saving the NHS over £13.5billion.

We live in an increasingly tough, financially prudent world, where savings have to be made at every possible avenue, and the NHS is no different. But, is there a cost to this burgeoning generic trade? More specifically, to patient health.

Some GPs understand there is a potential dip in effectiveness switching from a branded drug to the more inexpensive generic, and will occasionally even prescribe a higher dosage of the generic medicine to compensate. This means that somebody previously prescribed Lipitor 40mg daily for treating high cholesterol, may now suddenly receive a prescription for 80mg daily of Atorvastatin.

Potential Problems with Generic Medication

Unfortunately, this could bring some serious health implications to that patient. An increased statin dose means the patient is now at more risk of suffering with any number of reported side effects associated with statins, such as muscle pain and aches, liver damage, and even increased blood sugar levels, then maybe leading to type 2 diabetes.

It is certainly an issue that will cause mass debate, cost v health, which is ultimately more important? In the experience of Medical Specialists® and their patients, some men have reported previously being prescribed Viagra to treat erectile dysfunction, then were later given cheaper Generic Sildenafil after being unable to obtain Viagra, but now want the Viagra again to treat their erectile dysfunction.

Some have even said they have experienced slight headaches and feel flushed with the generic Sildenafil that they didn’t get with Viagra. It is an interesting trend emerging and one that needs to be explored in further depth.

Before we go on, it is best to understand a little about what branded and generic medicines actually mean. Often, the names of medicines can cause confusion, especially as the same medicine can sometimes be called numerous different names.

The brand name is given to a medicine by whichever pharmaceutical company developed it. For example and as previously mentioned, Pfizer’s erectile dysfunction treatment Viagra. The generic or scientific name for a drug is the active ingredient contained in it. Using the example of Viagra, the active ingredient is Sildenafil.

Since Pfizer lost its drug patent for Viagra back in 2013, other drug manufacturers can now produce ‘generic Sildenafil’, and sell this at a much lower price than the branded Viagra. The premise is similar to buying branded Heinz baked beans for instance, or the much cheaper supermarket’s own label. Both products will be pretty much the same, but the supermarket’s baked beans will be priced substantially less.

Legal Requirements of Generic Medication

Generic drugs have to have the same amount milligrams of drug displayed on the label within each of the pills. Moreover, each pill has to get the patient within 10% above or below the blood concentrations that are achieved with the branded drug in order to meet approval from the FDA in America or MHRA in the UK.

Commonly though, they will only vary by about 3% above or below. One generic could have a concentration 3% below the branded version, and another generic could be 3% above, representing a 6% difference between the generics, but patients will not notice a difference in this respect.

So could some of patient’s complaints and adverse reactions lay elsewhere? We have mentioned an active ingredient – i.e. Sildenafil – but there are also ‘inactive’ ingredients. There is no existing legislation by the FDA, MHRA, or other health bodies that says the generic’s inactive ingredients have to be the same as their brand version. These are irrelevant to the drug’s therapeutic action, but are instead components such as flavouring agents, dyes, preservatives and binding materials.

This explains why a branded medication you have previously taken, will now look different when you go to take the generic version. Pfizer’s Viagra is manufactured as a ‘little blue pill’, as it is famously known, whereas other manufacturers may produce sildenafil as a white-coloured and round-shaped pill.

However, with so many potential variations of the inactive ingredients, there is some degree of risk that a person may suffer with an adverse reaction from an inactive ingredient in a generic medication that wasn’t used in the branded version. Moreover, one generic can contain certain inactive ingredients that another generic does not.

Branded VS Generic Medication

In conclusion, are branded medicines that much better than their generic equivalents? As the generic drug makers are not the ones who developed it from scratch, the cost in bringing the drug to market is less, meaning they are cheaper than the branded drugs, explaining the price difference. The generic drug’s dose, safety, strength, quality, how it works and how it is taken should all be the same as the branded drug.

Could something be all in the mind? What we mean by this is, if you tell yourself and believe that something more expensive is better and will work better, does actually then go on to work better than a cheaper version. This is similar to what is known as a placebo effect; a patient’s belief in the treatment enough to somehow cause a desired effect. The mind and body working together to produce what the patient expects it to. Perhaps patients have high expectations of branded drugs, and little of generic drugs, so the former manage to work much more effective.

Whatever it is, it is a subject that does warrant further studies by drug manufacturers – why some people swear blind that a branded drug is giving them the effects that they say the generic is not, when the main mechanism of action is exactly the same.

Of course, everybody is different, and what works for one person could prove ineffective for somebody else. It is possible that there are patients who have been switched to cheaper generic alternatives and never notice any difference. After all, the main active ingredient is identical in both that and its more expensive branded counterpart.

At Medical Specialists® we supply many different branded and generic equivalents to suit everybody’s needs, such as the previously mentioned Pfizer Viagra and Generic Sildenafil, and much more.

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