4 ms·

What sorts of drugs treating what sorts of illness? My employer (Europe based) does work for pharmacies and they actively push customers to choose generics[1] b

What sorts of drugs treating what sorts of illness? My employer (Europe based) does work for pharmacies and they actively push customers to choose generics[1] because it's cheaper for the customer and the markup is higher (in price -> sales price = greater margin on generics even with a lower sales price than the non-generic). These are long established companies with vertical integration throughout the manufacturing and supply chain. This is a strictly regulated industry in Europe and I don't see them getting-away-with-it if there were health issues for the patient. I'm surprised to see so many comments here agreeing with the notion that generics are of lesser effect. [1] prescription drugs, not over the counter paracetamol.

beagle3 9y ago
It's likely a placebo effect. I'm not saying they are exactly equivalent -- things like particle sizes, buffers, release speed, etc (which are often different in different formulations) are known to make a difference. It is, however, extremely unlikely (to the point of impossibility) that every single brand name is better than every single equivalent generic. I have anecdotal evidence about a specific generic working significantly better than a related name brand for a specific person. There are specific studies showing a specific brand name is better than a specific [set of] generics. In the few cases I looked into it, that study was financed by the brand. They wouldn't publish a result saying the generic is better if that was the conclusion (and it's usually possible to p-hack a favorable result). I am not aware of generic manufacturers commissioning a study either way. I can accept a "75% of brands are better than generic" if it came from a well defined study. It's statistically impossible that "100% of brands are equal or better to generics".
- compuguy 9y ago
  Agreed. In the case of the drugs mentioned in the article (ADHD), the generic equivalents of the extended release aren't as good and/or potent as the brand name. This sucks because the generic drugs are so much cheaper, even with insurance.
briandear 9y ago
Europe is strictly regulated, yet those regulations, at least in France allow homeopathy to be prescribed despite absolutely no effect beyond a placebo. Almost every pharmacy in France is loaded up with homeopathic nonsense despite the “regulations.”
- gmac 9y ago
  On the other hand, the placebo effect can be pretty significant, and sugar pills have no side effects. So homoeopathic remedies could be a useful thing for doctors to prescribe to people who think they need a prescription but don't actually need one (certainly much better than antibiotics, which I'm pretty sure have sometimes filled this niche in the past).
- kagamine 9y ago
  Isn't that the right way to do it? Regulate against harm and leave the free market to sort out the nonsense? If someone wants to burn incense then let them.
atmosx 9y ago
I had specific examples of ACE, diuretics and PPIs generics in mind.

beagle3 9y ago

It's likely a placebo effect. I'm not saying they are exactly equivalent -- things like particle sizes, buffers, release speed, etc (which are often different in different formulations) are known to make a difference. It is, however, extremely unlikely (to the point of impossibility) that every single brand name is better than every single equivalent generic. I have anecdotal evidence about a specific generic working significantly better than a related name brand for a specific person. There are specific studies showing a specific brand name is better than a specific [set of] generics. In the few cases I looked into it, that study was financed by the brand. They wouldn't publish a result saying the generic is better if that was the conclusion (and it's usually possible to p-hack a favorable result). I am not aware of generic manufacturers commissioning a study either way. I can accept a "75% of brands are better than generic" if it came from a well defined study. It's statistically impossible that "100% of brands are equal or better to generics".

compuguy 9y ago
Agreed. In the case of the drugs mentioned in the article (ADHD), the generic equivalents of the extended release aren't as good and/or potent as the brand name. This sucks because the generic drugs are so much cheaper, even with insurance.

briandear 9y ago

Europe is strictly regulated, yet those regulations, at least in France allow homeopathy to be prescribed despite absolutely no effect beyond a placebo. Almost every pharmacy in France is loaded up with homeopathic nonsense despite the “regulations.”

gmac 9y ago
On the other hand, the placebo effect can be pretty significant, and sugar pills have no side effects. So homoeopathic remedies could be a useful thing for doctors to prescribe to people who think they need a prescription but don't actually need one (certainly much better than antibiotics, which I'm pretty sure have sometimes filled this niche in the past).
kagamine 9y ago
Isn't that the right way to do it? Regulate against harm and leave the free market to sort out the nonsense? If someone wants to burn incense then let them.

atmosx 9y ago

I had specific examples of ACE, diuretics and PPIs generics in mind.