With the advent of generic drugs the branded forms are also competing for prescription. while offering the best to the patient which is considered better. why is there no uniformity in pricing between generic and branded?
There is an international trend now which is moving to the generic prescribing, the reason as mentioned below:
There is considerable interest and debate concerning the place of generic substitution (switching from a brand to generic product); and on therapeutic substitution, that is, switching to a cheaper, but apparently equivalent, product, usually within the drug class. Generic substitution by pharmacists is standard practice in UK hospital settings, and is being proposed for implementation in primary care. Although most prescriptions are already written generically (83% in the community in England in 2008), there are still cost savings that could be made if generic medicines are substituted against prescriptions written by branded name or by getting prescribers to adhere to advice to prescribe generically.
However, there are cases where generic prescribing may not be appropriate, and in these cases drugs should be prescribed by brand name to ensure continuity of supply of a particular product and to avoid potential lack of effect, adverse effects due to toxicity or poor patient understanding, co-operation and adherence.
There is an international trend now which is moving to the generic prescribing, the reason as mentioned below:
There is considerable interest and debate concerning the place of generic substitution (switching from a brand to generic product); and on therapeutic substitution, that is, switching to a cheaper, but apparently equivalent, product, usually within the drug class. Generic substitution by pharmacists is standard practice in UK hospital settings, and is being proposed for implementation in primary care. Although most prescriptions are already written generically (83% in the community in England in 2008), there are still cost savings that could be made if generic medicines are substituted against prescriptions written by branded name or by getting prescribers to adhere to advice to prescribe generically.
However, there are cases where generic prescribing may not be appropriate, and in these cases drugs should be prescribed by brand name to ensure continuity of supply of a particular product and to avoid potential lack of effect, adverse effects due to toxicity or poor patient understanding, co-operation and adherence.
If quality of a generic drug is satisfactory, they are (or should be) the same. There is no compelling reason to use brand name drugs when their patents are already expired and they are already available as generic.
If a generic drug is not meeting the quality standards, it is more of an issue with the regulatory agency in the country in question - something that the government must fix for the safety of its people.
Government officials, doctors, researchers, and others who write about the new compound use the drug's generic name because it refers to the drug itself, not to a particular company's brand of the drug or a specific product. However, doctors often use the trade name on prescriptions, because it is easier to remember and doctors usually learn about new drugs by the trade name.
Since the introduction of generics, it was sparked to debate about the safety and efficacy compared to branded, but few trials have been conducted comparing about compliance. This was done in this case, considering the class of antihypertensives and 101 618 enrolled in the health service of the Lombardy Region (Northern Italy). The selected subjects - age = /> 18 years, monotherapy with a scratch antihypertensive generic or branded in 2008 - were followed up until the date of earlier discontinuation of therapy due to the medication (outcome). Based on a cohort and a self-controlled case series, were calculated hazard ratios (HR) of interruption associated with the initiation of treatment with a generic or brand and the ratio of the incidence rate (Irr) suspension during periods of treatment with the two categories of products. "The patients who had started treatment with generic not show a different risk of disruption than those who were left with a brand medication (hazard ratio, 1.00)," the authors write. "There were no even different rates of discontinuity during the periods covered by the two types of product (IRR: 1.01) in the same individuals' add. "These data have important clinical implications," the authors point out, "because a low persistence is associated with an increased risk of clinical outcomes," and, in the case of antihypertensives, to a higher incidence of hospitalizations for coronary or cerebrovascular disease. Note again two aspects. The substantial equality of membership, for scholars, is indicative of a substantial equivalence of antihypertensive in their impact on chronic therapeutic management in real life. From the data, finally, it was found that only a third of antihypertensive drugs prescribed was generic; figures in line with those of the entire Italian population but in contrast to the numbers of many European countries. "Assuming therapeutic equivalence" the authors conclude, "the clinical implication is to prescribe generic drugs."
J Hypertens, 2014 February 24. [Epub ahead of print]
One has to bear in mind that the therapeutic/effective dose of a drug has a range (even when corrected for difference in body weights), which allows for a certain latitude (consistent error as well as variation within samples) in a packaged size marked at a specific dose - the FDA permits it. Some of the generics manufacturers may be following somewhat relaxed standards than others, which will account for observed issues. I understand that compared to what was observed in the early 80's with L-Thyroxin, things have improved a great deal - at least, I hope so! ;)
But ultimately, it is the responsibility of our government to have standards in place and ensure that they are followed, as a part of licensing process for manufacturers. As long as that happens, there is absolutely no reason why there should be any discernible difference between brand names and generic pharmaceuticals.
While considering the price cap of non-essential medicines, the NPPA identified 8 therapeutic areas namely, anti-cancer, HIV/ AIDS, anti-TB, anti-malaria, cardiovascular, anti-diabetics, anti-asthmatic, and immunological (sera/ vaccines); where the incidence of disease was severe and where there was huge inter-brand price variation; even among generic/off patent drugs.
It will be interesting to see how long these restrictions imposed by the Indian Govt. will continue and how well will they actually be followed.
Personally, I have no issues with some companies pricing themselves out of business but that can only happen if the quality difference between various manufacturers is controlled and kept to a minimum. The main point is that the quality in generics and branded versions should be equal.
If someone wants to pay twice for a nicer looking bottle, they should be free to part from their money! ;)
Here the question of the bio equivalency and the therapeutic equivalency plays a very significant part in determining the quality of the medications, and of course the safety is also another concern in terms of the generic products, last but not least the pricing of the generic medications is another important parameter, if these factors are satisfactory met there is no doubt that clinicians will prescribe generics.