Understanding Pharmaceuticals
For many patients, there is still a lot of confusion about whether they should go for an originator drug, or a cheaper generic. It can be confusing, and the details of why we would choose one over the other are often not clear to those not in the medical field.
When we talk about drugs there is always the originator/innovator/ “brand leader” – this is the company that did the initial clinical trials to get the drug to market. Years of research have gone into the development of the new drug, which when released to the market, is normally patented.
There are 3 types of generics:
- Pseudo-generic/”clone” drug: These drugs are identical in all aspects to the originator drug, except for the name and identifying details on the label. In many cases they are actually made by the originator company!
- Licenced generic : These drugs have the same formulation as the original, but are made by a different company.
- True generic: A true generic has the same active ingredient as the originator, but has different inactive ingredients (sugar, flavour, preservatives etc).
Approval for a generic to be on the market is based on the generic company’s ability to demonstrate that their drug has the same therapeutic equivalence (or bioequivalence) as the originator product. All generics have to be safety tested, but generic companies are saving money (and thereby making drugs cheaper) as they are not having to do the initial research to develop the drug. Many of the originator companies have higher prices on their drugs as a portion of the money from each drug sale gets put back into research to develop new drugs, which might be something you would like to support, and thereby justifies the extra cost of the originator. You can find a lot of information on-line about many originator companies and what they are working on. If you are in support of the work they do, I do believe that the company would deserve your financial support.
It is important to understand – generics ARE safe, and generic companies do have to do trials that prove the bioequivalence of their drug.
The decision to prescribe a particular brand often rest’s with the doctor, but patients can request generics or a specific brand if cost is a concern, or you just have a personal preference. Often whether a patient gets the brand a doctor prescribes, or a different one, also depends on what is in stock at the pharmacy!
A WHO based study showed that prescribing of generics could save a patient (or the government, in a public funded system) between 9-89%. That is a significant difference, although clearly the range is quite large. We have seen this with the availability of generic ARV’s allowing many more people access to life-saving medication that was previously affordable.
On a personal note – many patients in South Africa don’t have a choice in what brand they choose – whether they are limited by their own finances, by their medical aid, or by what the public-sector has on tender. But for many of us we do have a choice – and not just with pharmaceuticals. The saying is “money makes the world go round” and in many ways that is true. I like to take a positive take on that saying and speak with my wallet – I buy products that I believe in, from companies and people that I believe deserve my support – they make quality products,that benefit myself, other people, and hopefully the environment and I would like to see them continue on the market, and be financially successful. If you’re in doubt about a product or company – do some research into them.