Executor
04-08-2008, 11:58 PM
Well folks, I've got some real stunning news for you....May surprise some, maybe not others. Some of you know I've been on the +/-15% thing for a while....Doing research & etc. I've talked to my pharmacist & Doc, among many others. I have hit this topic HARD, spending much of my free time on research. I've gotten very close, but couldn't quite put my finger on that last piece of research that cemented things firmly.
Well.....Today, I hit the mother load. I ran into an old friend who is now a pharmaceutical rep....Sells blood pressure meds & anti-depressants to GPs. He unlocked the holly grail for me and linked everything together. I asked him about this concept and he verified it 100%. He said that across the board, generics can be +/- 20%. He provided written information to me via e-mail and I've studied this over & over. Since we can't cut & paste, here is my translation in my own words:
Current FDA regulations permit a variation of up to 20% either way in the bioavailability of the active and inactive ingredient, according to Hatch-Waxman Act of 1999. In one study (Borgheini 2003), a 31% variation was found in the blood plasma levels of a particular medication after a patient switched from a branded to a generic product. Why does this happen? It is accounted for by differences in the manufacturing process yielding different ingredient qtys that are absorbed at different rates, as well as other factors. Some change the inactive ingredients, while others constantly change suppliers of raw material (drug compounds) in order to cut cost. I can assure you that a well run profit oriented drug company will be "under" (-20%) every time in order to cut costs and improve contribution margin due to the low market price.
Thus, this gives them a leeway of 40% (-20 to +20) on both active and inactive ingredients on manufacturing these drugs; they can be significantly different than their name brand counterparts, and in some cases the effect can mean a drug doesn't work at all, or may have too much of the active ingredient, resulting in serious effects or even fatalities! Generics are not equal to brands, and in fact are far from it!
So, as we all come on this board and talk about all our problems, I'm willing to bet most of the issues can be traced back to generics. Now....You may say "well, I've always been on generics".......Ok....BUT....Since the FDA gives them a 20% variation in each direction, that means generic vs generic, batch to batch, and even pill to pill (or patch to patch as we've discussed), you could be getting radically different drugs.
For me, I've spent tens of hours upon hours researching the fentanyl patch. I can pinpoint at least 100 testimonials (many on this board that are current as well as dated) that talk about how Mylan is much better than Sandoz while others swear Sandoz is better than Mylan. The feedback is pretty much 50/50. How the feedback be that erratic?
I've come to the conclusion that the wide variance in findings and testimonials is due to the +/- 20% variation permitted by the FDA. For example, this batch of Mylan may be right on target, the next batch weak, the next batch strong and so on. The same goes for other brands, thus, accounting for the wide variance. I'll go as far to say that some patches in a box are different than other patches....I've experienced this myself and thought that I was just having a bad day. I've also read many, many testimonials where others have said the same thing...I have to admit, I thought they were crazy at first.
My rep friend told me that this is a very controversial subject within the pharmaceutical industry that the big companies are trying to lobby the Gov't to change. His exact comment was "you know...for allergy medicine it may be alright to be off by 20%, but for blood pressure meds, it could kill you." I didn't tell him about my PM history, but the whole time he's providing me with this valuable information, I'm thinking.....Holly Cow.....What if my patches, or BT meds are varying by +/- 20% or 40% total...No wonder I have good days and bad days!!!
My conclusion.....I'm going to brand immediately and as long as I can afford such, I'm not wavering. My whole life depends on these meds and I"m not going to allow this variation to run my life. Everything make so much sense now! I realize the co-pays & etc. can get pricey, but to me, I can't afford not to. One suggestion I have....Pressure your Doc to write "DAW"...Dispense as Written on the script or "Brand name medically necessary"....Most policies will cover it and charge you the generic co-pay. Explain to your Doc that you've learned about this 20% thing and that the wide variation is affecting your health. At the very least, you'll have more consistent dosing of whatever med you take.
Hope this helps.
Ex
Well.....Today, I hit the mother load. I ran into an old friend who is now a pharmaceutical rep....Sells blood pressure meds & anti-depressants to GPs. He unlocked the holly grail for me and linked everything together. I asked him about this concept and he verified it 100%. He said that across the board, generics can be +/- 20%. He provided written information to me via e-mail and I've studied this over & over. Since we can't cut & paste, here is my translation in my own words:
Current FDA regulations permit a variation of up to 20% either way in the bioavailability of the active and inactive ingredient, according to Hatch-Waxman Act of 1999. In one study (Borgheini 2003), a 31% variation was found in the blood plasma levels of a particular medication after a patient switched from a branded to a generic product. Why does this happen? It is accounted for by differences in the manufacturing process yielding different ingredient qtys that are absorbed at different rates, as well as other factors. Some change the inactive ingredients, while others constantly change suppliers of raw material (drug compounds) in order to cut cost. I can assure you that a well run profit oriented drug company will be "under" (-20%) every time in order to cut costs and improve contribution margin due to the low market price.
Thus, this gives them a leeway of 40% (-20 to +20) on both active and inactive ingredients on manufacturing these drugs; they can be significantly different than their name brand counterparts, and in some cases the effect can mean a drug doesn't work at all, or may have too much of the active ingredient, resulting in serious effects or even fatalities! Generics are not equal to brands, and in fact are far from it!
So, as we all come on this board and talk about all our problems, I'm willing to bet most of the issues can be traced back to generics. Now....You may say "well, I've always been on generics".......Ok....BUT....Since the FDA gives them a 20% variation in each direction, that means generic vs generic, batch to batch, and even pill to pill (or patch to patch as we've discussed), you could be getting radically different drugs.
For me, I've spent tens of hours upon hours researching the fentanyl patch. I can pinpoint at least 100 testimonials (many on this board that are current as well as dated) that talk about how Mylan is much better than Sandoz while others swear Sandoz is better than Mylan. The feedback is pretty much 50/50. How the feedback be that erratic?
I've come to the conclusion that the wide variance in findings and testimonials is due to the +/- 20% variation permitted by the FDA. For example, this batch of Mylan may be right on target, the next batch weak, the next batch strong and so on. The same goes for other brands, thus, accounting for the wide variance. I'll go as far to say that some patches in a box are different than other patches....I've experienced this myself and thought that I was just having a bad day. I've also read many, many testimonials where others have said the same thing...I have to admit, I thought they were crazy at first.
My rep friend told me that this is a very controversial subject within the pharmaceutical industry that the big companies are trying to lobby the Gov't to change. His exact comment was "you know...for allergy medicine it may be alright to be off by 20%, but for blood pressure meds, it could kill you." I didn't tell him about my PM history, but the whole time he's providing me with this valuable information, I'm thinking.....Holly Cow.....What if my patches, or BT meds are varying by +/- 20% or 40% total...No wonder I have good days and bad days!!!
My conclusion.....I'm going to brand immediately and as long as I can afford such, I'm not wavering. My whole life depends on these meds and I"m not going to allow this variation to run my life. Everything make so much sense now! I realize the co-pays & etc. can get pricey, but to me, I can't afford not to. One suggestion I have....Pressure your Doc to write "DAW"...Dispense as Written on the script or "Brand name medically necessary"....Most policies will cover it and charge you the generic co-pay. Explain to your Doc that you've learned about this 20% thing and that the wide variation is affecting your health. At the very least, you'll have more consistent dosing of whatever med you take.
Hope this helps.
Ex
Sponsor
Boxerluver
04-09-2008, 12:14 AM
Executor,
Thanks for doing all the research. I'm like you, when I had fairly considerable differences in pain control I just figured I was having good or bad days. My husband would ask me if it was possible to get a "bad" patch and I said of course not. Looking back I know of specific times where I was doing really well then opened a new box of patches and went down hill. I'm glad to know what's really going on and from now on it's Brand for me!
Thanks again,
Melissa
Thanks for doing all the research. I'm like you, when I had fairly considerable differences in pain control I just figured I was having good or bad days. My husband would ask me if it was possible to get a "bad" patch and I said of course not. Looking back I know of specific times where I was doing really well then opened a new box of patches and went down hill. I'm glad to know what's really going on and from now on it's Brand for me!
Thanks again,
Melissa
cmpgirl
04-09-2008, 12:15 AM
Ex: I really have to thank you for this. I used to think I was insane or something. When I was taking generic Oxy, I would comment to my husband, some months, that I was sure that sometimes I was getting a "dud" or "bad" batch of meds. I would take them as usual, but would get far less relief and even mild w/d symptoms.
I thought about saying something to the pharmacy several times, but was afraid they would think I was either totally nuts or was accusing them of some sort of foul play. So, I just kept it pretty much to myself.
This finding explains a lot! Now I know it wasn't just me! Thank you so much for taking the time and making the effort to get to the bottom of this!
Again, thank you for helping me verify that I'm not totally nuts. cmpgirl
I thought about saying something to the pharmacy several times, but was afraid they would think I was either totally nuts or was accusing them of some sort of foul play. So, I just kept it pretty much to myself.
This finding explains a lot! Now I know it wasn't just me! Thank you so much for taking the time and making the effort to get to the bottom of this!
Again, thank you for helping me verify that I'm not totally nuts. cmpgirl
Executor
04-09-2008, 12:18 AM
Glad to help as I'm a firm believer that a high tide raises all boats!
For one who is on the 50Mcg patch for example, it can be anywhere from 40 to 60 Mcg....Within the same box. If you're on 40Mg Oxycontin generic, it can be in a range of 32 to 48Mg. Quite a window.
One could provide examples galore.
For one who is on the 50Mcg patch for example, it can be anywhere from 40 to 60 Mcg....Within the same box. If you're on 40Mg Oxycontin generic, it can be in a range of 32 to 48Mg. Quite a window.
One could provide examples galore.
trowftd3
04-09-2008, 12:22 AM
Shore used to always say...If you notice heart surgeons and transplant docs don't put their patients generic.or something to that effect.
The other day I went to pick up my husbands pain meds. I thought he got brand for both so I asked for brand and for some reason his percocet was $30. Our brand copay is $15. I still need to check that out.
Always get brand if you can afford it...and even if you can't because we rely on these drugs to LIVE! Take care.
Thanks for doing the work EX!
The other day I went to pick up my husbands pain meds. I thought he got brand for both so I asked for brand and for some reason his percocet was $30. Our brand copay is $15. I still need to check that out.
Always get brand if you can afford it...and even if you can't because we rely on these drugs to LIVE! Take care.
Thanks for doing the work EX!
123dietdrpepper
04-09-2008, 01:24 AM
I have noticed that when taking my oxy too. Right now I am on a good batch!! (Its brand name!!)
forginon
04-09-2008, 03:12 AM
I think we must be careful to realize that every manufacturing process is prone to variances in the end product. Even those involved in producing brand name drugs.
All throughout a manufacturing process there are allowable tolerances in both product quality and the devices measuring quality (or purity) levels. Equipment falls out of calibration regularly, and there are procedures in place to prevent and correct defects, but all production lines suffer variances in quality. Brand name manufacturers are just as dependent on the quality of bulk, raw materials as are the makers of generic drugs.
The point is that this isn't a good guys/bad guys thing with the makers of brand drugs in white hats and the generics in black. They're all in business to make money, and all suffer the same basic challenges. That the generics are allowed the +-20% is outrageous, and we have Ex to thank for bringing this to light. But we shouldn't be too quick to put brand manufacturers on a pedastel. I wouldn't be at all surprised to learn that there's likely a wider allowable variance in their purity batch to batch than we'd like to believe.
I can't afford for all my drugs to be brand. Even if I get my doc to write DAW on my script I still have to pay the higher copay. What I do is settle on the 'best' of the generics and stick with them. Endo makes my MS Contin generic and they do a fine job. I didn't even know how good they were until my pharmacy switched from Ethex to Endo - what a surprise! It felt like my dose had been raised.
I believe there are good generics out there, and I intend to use them as often as possible. I believe it's a bit extreme to attribute the majority of our 'off' days to the generics.
steve
All throughout a manufacturing process there are allowable tolerances in both product quality and the devices measuring quality (or purity) levels. Equipment falls out of calibration regularly, and there are procedures in place to prevent and correct defects, but all production lines suffer variances in quality. Brand name manufacturers are just as dependent on the quality of bulk, raw materials as are the makers of generic drugs.
The point is that this isn't a good guys/bad guys thing with the makers of brand drugs in white hats and the generics in black. They're all in business to make money, and all suffer the same basic challenges. That the generics are allowed the +-20% is outrageous, and we have Ex to thank for bringing this to light. But we shouldn't be too quick to put brand manufacturers on a pedastel. I wouldn't be at all surprised to learn that there's likely a wider allowable variance in their purity batch to batch than we'd like to believe.
I can't afford for all my drugs to be brand. Even if I get my doc to write DAW on my script I still have to pay the higher copay. What I do is settle on the 'best' of the generics and stick with them. Endo makes my MS Contin generic and they do a fine job. I didn't even know how good they were until my pharmacy switched from Ethex to Endo - what a surprise! It felt like my dose had been raised.
I believe there are good generics out there, and I intend to use them as often as possible. I believe it's a bit extreme to attribute the majority of our 'off' days to the generics.
steve
Shoreline
04-09-2008, 07:14 AM
Steve makes a good point, That vairiance is there because it's also exceptable in brand name products by the FDA. If you give a 100 different people at the same weight, the same dose you will see the same variances. These are exceptable variances within any product do to several factors, age, metabolism, sex, even race have an effect on some drugs. My problem is when one company is constantly inferrior. My wife was in the retail pharma biz for several years and pharmies are paid a bonis to maintain a certain percentage of generic sales due to the high profit margin, we may save 30% on a generic but the retailer is making double the profit and pharmies are rewarded financially for telling every customer that their generics are equivelant and meet the highest FDA standards, which they do.
Anyway, I read that info in AARP 10 years ago, I'm not that old but the younger folks may actually be able to learn something from folks that remeber the days when percocet was only drug dispensed for post op pain, CP wasn't treated with opiates and there was no such thing as a 10 mg Percocet, Oxycontin or Duragesic.
BTW. The generic version of OxyC was removed for the third time in 10 years because Purdue reformulated the contin sytem at the request of the FDA when looking for a more abuse resistant version. Equally important to Purdue, they maintain a monopoly on LA oxycodone after 12 years. They now use the Acro Contin system which works closer to the way Exec described as far as smoother more continous release rather than the old double release or dual phasic. Because the generics were modeled after the old delivery system, they aren't truley an equivelant product and have the same flaws that the original name brand formulation had.This is why Purdue won their case again, along with Billions in campaign contibutions in the last 10 years and more lobbying power than tobaco, guns and alcohol combined.
Thanks for verifying that for us Exec. Good luck with your research.
Dave
Anyway, I read that info in AARP 10 years ago, I'm not that old but the younger folks may actually be able to learn something from folks that remeber the days when percocet was only drug dispensed for post op pain, CP wasn't treated with opiates and there was no such thing as a 10 mg Percocet, Oxycontin or Duragesic.
BTW. The generic version of OxyC was removed for the third time in 10 years because Purdue reformulated the contin sytem at the request of the FDA when looking for a more abuse resistant version. Equally important to Purdue, they maintain a monopoly on LA oxycodone after 12 years. They now use the Acro Contin system which works closer to the way Exec described as far as smoother more continous release rather than the old double release or dual phasic. Because the generics were modeled after the old delivery system, they aren't truley an equivelant product and have the same flaws that the original name brand formulation had.This is why Purdue won their case again, along with Billions in campaign contibutions in the last 10 years and more lobbying power than tobaco, guns and alcohol combined.
Thanks for verifying that for us Exec. Good luck with your research.
Dave
zoey1
04-09-2008, 08:35 AM
i have noticed a huge difference in the synthroid meds and found i could not take generic syn thyroid at all. Had to fight insurance company and ended up finding stores that sell the brand name cheaper. But i also have had allergic reactions to certain meds lately. More so then before.
My latest severe reaction was Watson which was doctor document as well. Part of the issue which may or may not have been stated ANYWHERE is folks do not go in when they have a severe reaction and get it documented. Or they go in and the doc is TOO busy to document it and send it in. This last bad reaction ( last week) i not only had the doctor fill out the bad reaction report right in front of me, but the pharmacists became aware of the severe allergic reaction too.
So there is a food chain , that is suppose to be followed. I am beginning to wonder after your research is part of the problem is folks reporting it and doctors/pharmacies not following through with reporting it to FDA because of revenue /gifts given to docs from various drug companies?
My latest severe reaction was Watson which was doctor document as well. Part of the issue which may or may not have been stated ANYWHERE is folks do not go in when they have a severe reaction and get it documented. Or they go in and the doc is TOO busy to document it and send it in. This last bad reaction ( last week) i not only had the doctor fill out the bad reaction report right in front of me, but the pharmacists became aware of the severe allergic reaction too.
So there is a food chain , that is suppose to be followed. I am beginning to wonder after your research is part of the problem is folks reporting it and doctors/pharmacies not following through with reporting it to FDA because of revenue /gifts given to docs from various drug companies?
Shoreline
04-09-2008, 12:42 PM
Hey Exec, My brother was qualtiy control for bayers special blood products so I sent him a 10 mg Methdose tablet to annalyze after having gone through withdawal for the second time whan I was given that brand from the pharamcy, The 10 mg tablet came back as having 8.2 mgs of actual methadone in the tablet. I complained to the FDA, the FDA directed me to Mallinkrodt, the manufacturer of methadose. I contacted mallinkrodt with the contact info I was given by the FDA and was directed to mallinkrodts PR division where I was politely told that all their products meet or exceed the highest standards and all carry the highest AB rating as set forth by the by the FDA. I basically reported them to the authorities and then was directed to the public relations dept of that company just in case they felt like policing themself. The entire experience was a big joke.
There are alot of problems, It's not just bush, Hilary C collected more money from pharamcuetical lobbyist for this campaign than all the other candidates combined. She had a big part in the medicare part D push however the govt decided not to negotiate prices with any pharamcuetical company on medicares' behalf? Why? Obviously this isn't a political forum, but it's hardly one party or administrtation that has gotten fat from the incrediable profits made in this buisness.
People get mad about a 10% mark up on the car they buy,when they ought to be mad about the 500,000% markup from a kilo of bulk alprozolam to a bottle of 100 1 mg Xanax tablets on the shelf. Yes, a half million percent markup. That came from another AARP newslettter that listed the top fifty drugs and their markup from a kilo of pure drug to the time it hits the pharamcy shelf. From pennies a kilo to a buck a pill for name brand. The lowest drug on that list was around 5,000% gross mark-up from kilo to shelf. What other industry works on this kind of gross margin?
More tidbits to ponder ;)
Dave
There are alot of problems, It's not just bush, Hilary C collected more money from pharamcuetical lobbyist for this campaign than all the other candidates combined. She had a big part in the medicare part D push however the govt decided not to negotiate prices with any pharamcuetical company on medicares' behalf? Why? Obviously this isn't a political forum, but it's hardly one party or administrtation that has gotten fat from the incrediable profits made in this buisness.
People get mad about a 10% mark up on the car they buy,when they ought to be mad about the 500,000% markup from a kilo of bulk alprozolam to a bottle of 100 1 mg Xanax tablets on the shelf. Yes, a half million percent markup. That came from another AARP newslettter that listed the top fifty drugs and their markup from a kilo of pure drug to the time it hits the pharamcy shelf. From pennies a kilo to a buck a pill for name brand. The lowest drug on that list was around 5,000% gross mark-up from kilo to shelf. What other industry works on this kind of gross margin?
More tidbits to ponder ;)
Dave
feelbad
04-09-2008, 01:01 PM
great info ex,really. we found out the hard way back in 2000 when my son was given a different generic prednisone that was not the one he had been stabilized on and he almost lost his "new' liver. from what his transplant surgeon told me about the so called generic "equivalent" back then really kind of scared the crap outta me. there can be that leeway you mentioned and can even go as high as 110% OVER ,yes you can also be overdosed, that active ingedient amount. i was stunned that just being given a different generic than the one my son was started and had been on for like months(almost a full year with no issues) could actully be different enough to start the rejection process in him. when they checked his pred levels there was actually 20% LESS in his system than there should have been and what had been stable with the other brand. this was one really sick way to find this out. honestly. but that was my first introduction into the world of the alleged generic equivalents. it almost cost us our child.
in the types of meds that have whats called a narrow thereputic index,these are the transplant meds,and anti seizure meds,and blood thinners like coumadin,the ones where the dosages just HAVE to be right on target every single time or an event will occur? that is where the generics really cause the most problems and or death in some cases. they just have to be that exacting. these patients are the ones who suffer the most from this and its just a really sick thing to do to a person.
if you have ever gotten your hands on a copy of the best of the peoples pharmacy it is a really in depth read on what the so called generic equivalents are all about. these people used to actually advocate the use of the generics til they started getting mail from people who were experincing amazingly sick repercussions in using them. there is a chapter in that book that details their 'mission" to find out the real truth from asking all the right questions from all the right people,some who worked in these drug companies. now,there thinking is totally the opposite after finding out the actual truths of the generics.
they also mentioned just how many different hands our drugs go thru as compared to canada,and how much safer the canadian system is than in the US,just because the canadian system has many many less distributors. its just really a very scarey world out there in our US system.
what really should make everyone sick is the FDA has known about the so called generic equivalent since the beginning and condones it. great info there ex and of course shore. good to hear from you dave. missed ya. marcia
in the types of meds that have whats called a narrow thereputic index,these are the transplant meds,and anti seizure meds,and blood thinners like coumadin,the ones where the dosages just HAVE to be right on target every single time or an event will occur? that is where the generics really cause the most problems and or death in some cases. they just have to be that exacting. these patients are the ones who suffer the most from this and its just a really sick thing to do to a person.
if you have ever gotten your hands on a copy of the best of the peoples pharmacy it is a really in depth read on what the so called generic equivalents are all about. these people used to actually advocate the use of the generics til they started getting mail from people who were experincing amazingly sick repercussions in using them. there is a chapter in that book that details their 'mission" to find out the real truth from asking all the right questions from all the right people,some who worked in these drug companies. now,there thinking is totally the opposite after finding out the actual truths of the generics.
they also mentioned just how many different hands our drugs go thru as compared to canada,and how much safer the canadian system is than in the US,just because the canadian system has many many less distributors. its just really a very scarey world out there in our US system.
what really should make everyone sick is the FDA has known about the so called generic equivalent since the beginning and condones it. great info there ex and of course shore. good to hear from you dave. missed ya. marcia
ozzybug
04-09-2008, 03:17 PM
Executor-
Thank you for the hard work in doing a deep and thorough study about this. I had always heard and read that there was an allowable variance in the generics and never really thought that much about it until my pharmacy switched from Watson to Mallinkrodt with one of my meds.
The Watson was great and never seemed to bounce up and down as far as effectiveness, BUT when this pharmacy merged with another large chain pharmacy, I noticed the pills looked totally different. After looking, I found that instead of Watson, it was Mallindrodt. I called the pharmacy and was told that this is the version they will carry from now on. I asked if they could order the Watson for me and was told no.
My honest opinion about the Mallinkrodt is that it's FAR inferior, and I never know how well they will work. Sometimes they seem ok, and then other times the entire month is bad for me as far as pain levels remaining "consistant".
I think I'll talk with my PM doctor at my appointment in May and ask him about making all of my meds "Name brand medically necessary" from now on. He does that with some of my meds already, so he should be ok with this. It will certainly be worth the extra money to know I'm not getting medications that have so much room for variances.
Thanks again! You've given us all something to seriously think about here. :)
Thank you for the hard work in doing a deep and thorough study about this. I had always heard and read that there was an allowable variance in the generics and never really thought that much about it until my pharmacy switched from Watson to Mallinkrodt with one of my meds.
The Watson was great and never seemed to bounce up and down as far as effectiveness, BUT when this pharmacy merged with another large chain pharmacy, I noticed the pills looked totally different. After looking, I found that instead of Watson, it was Mallindrodt. I called the pharmacy and was told that this is the version they will carry from now on. I asked if they could order the Watson for me and was told no.
My honest opinion about the Mallinkrodt is that it's FAR inferior, and I never know how well they will work. Sometimes they seem ok, and then other times the entire month is bad for me as far as pain levels remaining "consistant".
I think I'll talk with my PM doctor at my appointment in May and ask him about making all of my meds "Name brand medically necessary" from now on. He does that with some of my meds already, so he should be ok with this. It will certainly be worth the extra money to know I'm not getting medications that have so much room for variances.
Thanks again! You've given us all something to seriously think about here. :)
Executor
04-09-2008, 04:19 PM
I contacted mallinkrodt with the contact info I was given by the FDA and was directed to mallinkrodts PR division where I was politely told that all their products meet or exceed the highest standards and all carry the highest AB rating as set forth by the by the FDA.
Shore- Great Story! Thanks for sharing. This is just another example that validates what we're all talking about. Kinda interesting that they would come back with "meet or exceed the highest standards" B.S. I guess technically they do, because @ 8.2Mg, they are only 18% off, so they exceed the 20% standard!
Amazing isn't it?
Ex
Shore- Great Story! Thanks for sharing. This is just another example that validates what we're all talking about. Kinda interesting that they would come back with "meet or exceed the highest standards" B.S. I guess technically they do, because @ 8.2Mg, they are only 18% off, so they exceed the 20% standard!
Amazing isn't it?
Ex
Executor
04-09-2008, 04:22 PM
I called the pharmacy and was told that this is the version they will carry from now on. I asked if they could order the Watson for me and was told no.
If your Doc won't write "DAW" or "medically necessary" then maybe you could try and independent pharmacy. I have found the independent guys to be much more customer service driven. Hopefully though, your Doc will help you.
Speaking of which, I think it's critical to all who go this route to make sure you let the Doc you know about the -20% law....This should convince him/her that you've done your homework and can't be B.S.'d.
Going brand may not solve all your problems, but at the very least, you get more consistent meds.
Ex
If your Doc won't write "DAW" or "medically necessary" then maybe you could try and independent pharmacy. I have found the independent guys to be much more customer service driven. Hopefully though, your Doc will help you.
Speaking of which, I think it's critical to all who go this route to make sure you let the Doc you know about the -20% law....This should convince him/her that you've done your homework and can't be B.S.'d.
Going brand may not solve all your problems, but at the very least, you get more consistent meds.
Ex
Executor
04-09-2008, 04:25 PM
great info ex,really. we found out the hard way back in 2000 when my son was given a different generic prednisone that was not the one he had been stabilized on and he almost lost his "new' liver. from what his transplant surgeon told me about the so called generic "equivalent" back then really kind of scared the crap outta me. there can be that leeway you mentioned and can even go as high as 110% OVER ,yes you can also be overdosed, that active ingedient amount. i was stunned that just being given a different generic than the one my son was started and had been on for like months(almost a full year with no issues) could actully be different enough to start the rejection process in him. when they checked his pred levels there was actually 20% LESS in his system than there should have been and what had been stable with the other brand. this was one really sick way to find this out. honestly. but that was my first introduction into the world of the alleged generic equivalents. it almost cost us our child.
Sooo sorry Marcia to hear about this, but I very much appreciate you sharing because every story lends more credibility to the situation. Also, the way I read the law, you can go as much as 20% over, or 120%.
Ex
Sooo sorry Marcia to hear about this, but I very much appreciate you sharing because every story lends more credibility to the situation. Also, the way I read the law, you can go as much as 20% over, or 120%.
Ex
gregar
04-09-2008, 05:20 PM
This is sad news. It's no wonder I had such bad problems with the Fentanyl patch, and various other pain meds. With the patch I was started on 25mcg and after about a week with this not working as well as my doctor wanted moved to 2 x25 mcg, every 2 days ( they didn't last anywhere near the 3 days they say they should ). 50mcg was good for me so when I used up the 25mcg the doctor wrote me out a prescription for 50mcg patch. I got much better relieve from the 2x25mcg then the one 50mcg. And what was even worse was when I got the 50mcg they changed the brand from Sandoz to Mylan. The Mylan on top of making me very sick was to the point of throwing up, they didn't even touch the pain. So I called up the pharmacy and they exchanged all but one that I had started wearing for the 50mcg Sandoz. But even these didn't work as well as the two 25mcg. And after much issues with rashes and trying to find a good place to place the patch on my much hairy body :o He took me off the patch and I'm now on Oxycontin.
Now we come to a different issue. These things do not work 12 hours for me, and even worse, they don't even work 6 hours. For some reason the second dose that should be released at around 6 hours after taking it doesn't happen. So I'm on 30mg 4xdaily. The pharmacist looked at me like there was something wrong with me, called my doctor and asked if this prescription was correct and then asked why I needed so much so often. Now that's a question I'd also like answered too. I see lots of posts where people are having to take oxycontin 3x daily and even that shouldn't be happening. Where are the companies getting the info on how long their drugs last? Do they do studies? Are they actually testing on people that are in pain or just random people telling them how long they get the side effects from the meds? :( Sorry, I'm rambling again. I just want a normal life back where I can be happy and at least mostly pain free without feeling like a zombie. I'm getting so tired of this but I have good people helping me to deal with my issues, without them I don't know what I'd do.
HUGS
Now we come to a different issue. These things do not work 12 hours for me, and even worse, they don't even work 6 hours. For some reason the second dose that should be released at around 6 hours after taking it doesn't happen. So I'm on 30mg 4xdaily. The pharmacist looked at me like there was something wrong with me, called my doctor and asked if this prescription was correct and then asked why I needed so much so often. Now that's a question I'd also like answered too. I see lots of posts where people are having to take oxycontin 3x daily and even that shouldn't be happening. Where are the companies getting the info on how long their drugs last? Do they do studies? Are they actually testing on people that are in pain or just random people telling them how long they get the side effects from the meds? :( Sorry, I'm rambling again. I just want a normal life back where I can be happy and at least mostly pain free without feeling like a zombie. I'm getting so tired of this but I have good people helping me to deal with my issues, without them I don't know what I'd do.
HUGS
Arthr Itis
04-09-2008, 05:25 PM
This all explains why when my pharmacy couldn't fill my oxy script with generic yesterday I ok'ed name brand. Today it feels like I've upped my dose.
I wonder just how much the name brands can fluctuate. I have a friend in a pharmacy, I wonder if he knows.
I agree with Shore, it doesn't matter which party is in office. They all do it!
Fred
I wonder just how much the name brands can fluctuate. I have a friend in a pharmacy, I wonder if he knows.
I agree with Shore, it doesn't matter which party is in office. They all do it!
Fred
Executor
04-09-2008, 09:17 PM
This all explains why when my pharmacy couldn't fill my oxy script with generic yesterday I ok'ed name brand. Today it feels like I've upped my dose.
I wonder just how much the name brands can fluctuate.
There will be some small variation in manufacturing....It's impossible to be perfect. When I worked @ a fortune 5 manufacturing company, we strived for six sigma or 3.4 defects per million opportunities. In reality however, we routinely hit about 5 defects per million and our variation was less than 2% on any given SKU at any given time....Very nominal.
We can all live with small, normal variation. The thing with generics, however, is that they are allowed to be -20% variation....This is what causes the problems. Instead of a 10Mg of Oxy, it's 8 or instead of a 40Mg of Oxy, it's 32. And, to me, what's very concerning, is that bigger the dose you're on, the bigger the variance.....20% of a bigger number is a bigger number!! Just imagine those who are on 200Mg of Oxy per day...It can be as low as 160 (.8 of 200).
Ex
I wonder just how much the name brands can fluctuate.
There will be some small variation in manufacturing....It's impossible to be perfect. When I worked @ a fortune 5 manufacturing company, we strived for six sigma or 3.4 defects per million opportunities. In reality however, we routinely hit about 5 defects per million and our variation was less than 2% on any given SKU at any given time....Very nominal.
We can all live with small, normal variation. The thing with generics, however, is that they are allowed to be -20% variation....This is what causes the problems. Instead of a 10Mg of Oxy, it's 8 or instead of a 40Mg of Oxy, it's 32. And, to me, what's very concerning, is that bigger the dose you're on, the bigger the variance.....20% of a bigger number is a bigger number!! Just imagine those who are on 200Mg of Oxy per day...It can be as low as 160 (.8 of 200).
Ex
niap
04-10-2008, 12:04 AM
i agree, i take tevas 10 mg oxys and i can feel a difference in pain control from pill to pill. Thanks for the info, hopefully the brand will be more constant for me!
niap
niap
Arthr Itis
04-10-2008, 11:06 AM
This is so depressing! Being totally disabled and on a fixed income the difference between the $40. co-pay for name brand and $10 for generic is a big deal. It's a matter of what else can I give up in order to pay for the name brand.
Fred
Fred
feelbad
04-10-2008, 12:03 PM
i just wanted to mention something else that was brought up in that peoples pharmacy book? believe it or not,becasue of major cutbacks at the FDA with the drug co inspectors,they are not actually even inspecting the drug co the two required times per year. there are actually generic drug cos out there who have been around for years and have never had even one inspection done or "suprise' visits from the FDA. alot of these companies are basically on their 'honor' system. that really makes me sick when you think about like everyone in the US is actually on some type of an Rx med.
just between how many distributors our meds go thru and all the non inspections going on,who the heck even knows just what actually is even IN some of the meds we take everyday or give to our children. the whole system is sick and needs fixing. they have actually found many different types of counterfit meds sitting on the shelves in actual drug stores in some cities. thats insane. 20/20 did an expose on that last year. unbelievable.
like i mentioned before,i think we all need to move to canada. its just plain scarey here. i am going to go hide in my closet now,bye. marcia
just between how many distributors our meds go thru and all the non inspections going on,who the heck even knows just what actually is even IN some of the meds we take everyday or give to our children. the whole system is sick and needs fixing. they have actually found many different types of counterfit meds sitting on the shelves in actual drug stores in some cities. thats insane. 20/20 did an expose on that last year. unbelievable.
like i mentioned before,i think we all need to move to canada. its just plain scarey here. i am going to go hide in my closet now,bye. marcia
forginon
04-10-2008, 12:07 PM
Fred,
Why not just take it one step at a time.
Just buy the brand meds for one month and evaluate them. If you notice a measurable difference, then you face the hard budget choices. If you do not notice a measurable difference, then no harm done, right? Except you're out $30, which is probably well worth it.
You just have to be very careful to make your evaluation as objective as possible, and I'm not quite sure how to do that.
I need to be clear that I really, really appreciate the homework Ex has done on this. What a great service for all of us. But I want to be equally clear that I do not think variance in generics can be blamed for day-to-day ups and downs regarding pain. Month-by-month, or batch to batch maybe. But, IMHO, there is so much more variability in the human body and in how it reacts to its environment and what goes on on the inside, than there could ever be with generic medications - that more than likely day-to-day differences in pain and mood are probably much more likely attributable to the pain causing condition, the food we eat, or do not eat, other con-committant conditions, reactions between medications, interpersonal relationships and their effect on our bodies, stress, and on, and on, and on.
If you do choose to conduct an evaluation, try to take your pain score a few times each day, and do it at the same times each day. Do one month on the generic and one month on the brand drug. For each data entry (pain score) be sure to note other factors that may be playing into the recorded score like illnesses, stress, medication changes (other meds), you name it. Then, at the end of the two months, sit down and evaluate the results. If there is a clear winner, great. If not, maybe the generic isn't such a bad thing after all.
steve
Why not just take it one step at a time.
Just buy the brand meds for one month and evaluate them. If you notice a measurable difference, then you face the hard budget choices. If you do not notice a measurable difference, then no harm done, right? Except you're out $30, which is probably well worth it.
You just have to be very careful to make your evaluation as objective as possible, and I'm not quite sure how to do that.
I need to be clear that I really, really appreciate the homework Ex has done on this. What a great service for all of us. But I want to be equally clear that I do not think variance in generics can be blamed for day-to-day ups and downs regarding pain. Month-by-month, or batch to batch maybe. But, IMHO, there is so much more variability in the human body and in how it reacts to its environment and what goes on on the inside, than there could ever be with generic medications - that more than likely day-to-day differences in pain and mood are probably much more likely attributable to the pain causing condition, the food we eat, or do not eat, other con-committant conditions, reactions between medications, interpersonal relationships and their effect on our bodies, stress, and on, and on, and on.
If you do choose to conduct an evaluation, try to take your pain score a few times each day, and do it at the same times each day. Do one month on the generic and one month on the brand drug. For each data entry (pain score) be sure to note other factors that may be playing into the recorded score like illnesses, stress, medication changes (other meds), you name it. Then, at the end of the two months, sit down and evaluate the results. If there is a clear winner, great. If not, maybe the generic isn't such a bad thing after all.
steve
Executor
04-10-2008, 12:09 PM
Marcia- Great addition to the thread! You're exactly right, when the cat is away, the mice will play.
I know going brand will undoubtedly put a financial strain on many, but for me, I can't afford not to do it, even if it means doing without some other things in my life. If I feel bad, I can't enjoy some of those other things anyway.
Shore's example of what happened with the Methadose really hits home for me. Not only did it completely back up what we've been talking about, but as consumers, we are paying for one thing, and getting another. Why is OC 20 more expensive than OC10? Because you get more of the drug. Why are you paying for Methadose 10 when you get 8.2???? Because the drug companies are taking advantage of a loophole. What a racket.
Ex
I know going brand will undoubtedly put a financial strain on many, but for me, I can't afford not to do it, even if it means doing without some other things in my life. If I feel bad, I can't enjoy some of those other things anyway.
Shore's example of what happened with the Methadose really hits home for me. Not only did it completely back up what we've been talking about, but as consumers, we are paying for one thing, and getting another. Why is OC 20 more expensive than OC10? Because you get more of the drug. Why are you paying for Methadose 10 when you get 8.2???? Because the drug companies are taking advantage of a loophole. What a racket.
Ex
Moldova
04-10-2008, 07:19 PM
Ex,
I believe last year i posted on this board about generic vs main brand.
I am lucky to have my pharmacist as my neighbor and she told me last year about all you just posted.
I had my app today with PM DR. He put me on LA Oxycontin meds and asked me if I have a good insurance. I asked him why? He said I want you to have brand name; many generic meds are not working as well, in many cases it's waist of time and money. Same he told me about Percocet last year.
He also said that patients in a hospitals all get generic meds, this is the rule, but if I can afford brand narco meds, he would prefer me to have them instead of generic.
I appreciate his honesty and honesty of my Pharmacist. I knew the rule "you get what you pay fore", it has to be the reason why generic is less expensive and here you are!
So since than I would never use generic.
Good luck to all of you!:angel:
I believe last year i posted on this board about generic vs main brand.
I am lucky to have my pharmacist as my neighbor and she told me last year about all you just posted.
I had my app today with PM DR. He put me on LA Oxycontin meds and asked me if I have a good insurance. I asked him why? He said I want you to have brand name; many generic meds are not working as well, in many cases it's waist of time and money. Same he told me about Percocet last year.
He also said that patients in a hospitals all get generic meds, this is the rule, but if I can afford brand narco meds, he would prefer me to have them instead of generic.
I appreciate his honesty and honesty of my Pharmacist. I knew the rule "you get what you pay fore", it has to be the reason why generic is less expensive and here you are!
So since than I would never use generic.
Good luck to all of you!:angel:
Executor
04-10-2008, 10:01 PM
Moldova- Sounds like you have a great team of health care people around you. I too have a great pharmacist....Not a neighbor, but someone who treats me like a patient, not a pain. He has been responsible for a vast amount of my PM education. Without him, I'm not sure I would make it. He has done sooo much for me.
I hope the LA OC works for you!
Ex
I hope the LA OC works for you!
Ex
HappyFlower
04-10-2008, 11:28 PM
If you ask for brand are you labled as a "addict" or "seeker"? I have a friend who swears that is why she was dropped by her PM...her PM is different than mine and in a different state..
I find this very, very interesteing and I thank you Executor for taking the time to post it. Also, thanks to the others who added info and more "tidbits" to ponder. The first time I was on the Mallinkrap brand I was on here two days later asking what the snot was going on..I got NO relief and was in mini withdrawls!!
Thanks again...HappyFlower
I find this very, very interesteing and I thank you Executor for taking the time to post it. Also, thanks to the others who added info and more "tidbits" to ponder. The first time I was on the Mallinkrap brand I was on here two days later asking what the snot was going on..I got NO relief and was in mini withdrawls!!
Thanks again...HappyFlower
Executor
04-11-2008, 01:41 AM
If you ask for brand are you labled as a "addict" or "seeker"? I have a friend who swears that is why she was dropped by her PM...her PM is different than mine and in a different state..
I sure hope not! If you are that concerned about it, simply ask your Doc to specify brand because the pharmacist told you they've got a lot of complaints about the generic and you've noticed a difference too. The most conservative approach would to not say anything to your Doc, and then just request brand at the pharmacy and pay the difference, assuming you could afford it. The Doc would never know.
Patients should be able to have candid conversations with their Doc's, but each one is different and based on some of the horror stories I've read on this board, nothing would surprise me.....Unfortunately.
Ex
I sure hope not! If you are that concerned about it, simply ask your Doc to specify brand because the pharmacist told you they've got a lot of complaints about the generic and you've noticed a difference too. The most conservative approach would to not say anything to your Doc, and then just request brand at the pharmacy and pay the difference, assuming you could afford it. The Doc would never know.
Patients should be able to have candid conversations with their Doc's, but each one is different and based on some of the horror stories I've read on this board, nothing would surprise me.....Unfortunately.
Ex
feelbad
04-11-2008, 01:47 PM
i really cannot imagine being labled as a drug seeker by wanting a better quality med. my PM also had no problems what so ever switching me back to name brand when i was,for only two weeks,on that horrid endo brand of the oxycontin and got no real pain relief from it. there is simply no possible way in heck that the endo could contain the very same amount of oxy as the name,no way,not with the pitiful results i got from it. i also got severe nausea and headaches that were just 'there",very light but there from the on set of this wonderful generic equvalent.
that delivery system was also very different as those 'ghost matrixes" that are always there when you take the name brand,simply weren't there with the endo. i am thinking either there was not enough in it to do the job,or it had something to do with that strange delivery system it has. either way. i started asking for the DAW to be written on every single OC Rx now and have had no problems with that at all. and my PM is totally fine with doing it for me.
when something obviously is not working for you when it once was on either a name brand or other generic,something is very wrong with that particular med.
just some more 'confirming" type of info for ya, despite the fact that with alot of my sons Tx meds alot of them actually have generics availiable now,but his Tx surgeon ALWAYS demands name brand,so we do pay higher co pays now,but i KNOW we are getting the best possible meds with the proper dosage and don;t have to worry about what happened to him before. plus,we obtain only his tx meds from the u of MN hosp where he actually had his tx. i just know that 'they' know what is best for the Tx patients there. i refuse to have to watch my son go thru hell again simply becasue the meds we are relying on to keep him in non rejection status are "off' by way too much. this med program was the best thing we could possibly have done for him in ensuring quality,only becasue they DO know what the story is on the alleged generic equivalents.thank god. i don't know what the FDA has read about the "word' eqivalent,but in my websters dictionary,it states something that is equal to or the "same as" duh! Marcia
that delivery system was also very different as those 'ghost matrixes" that are always there when you take the name brand,simply weren't there with the endo. i am thinking either there was not enough in it to do the job,or it had something to do with that strange delivery system it has. either way. i started asking for the DAW to be written on every single OC Rx now and have had no problems with that at all. and my PM is totally fine with doing it for me.
when something obviously is not working for you when it once was on either a name brand or other generic,something is very wrong with that particular med.
just some more 'confirming" type of info for ya, despite the fact that with alot of my sons Tx meds alot of them actually have generics availiable now,but his Tx surgeon ALWAYS demands name brand,so we do pay higher co pays now,but i KNOW we are getting the best possible meds with the proper dosage and don;t have to worry about what happened to him before. plus,we obtain only his tx meds from the u of MN hosp where he actually had his tx. i just know that 'they' know what is best for the Tx patients there. i refuse to have to watch my son go thru hell again simply becasue the meds we are relying on to keep him in non rejection status are "off' by way too much. this med program was the best thing we could possibly have done for him in ensuring quality,only becasue they DO know what the story is on the alleged generic equivalents.thank god. i don't know what the FDA has read about the "word' eqivalent,but in my websters dictionary,it states something that is equal to or the "same as" duh! Marcia
IZZY'SMOM
04-11-2008, 08:20 PM
There will be some small variation in manufacturing....It's impossible to be perfect. When I worked @ a fortune 5 manufacturing company, we strived for six sigma or 3.4 defects per million opportunities. In reality however, we routinely hit about 5 defects per million and our variation was less than 2% on any given SKU at any given time....Very nominal.
We can all live with small, normal variation. The thing with generics, however, is that they are allowed to be -20% variation....This is what causes the problems. Instead of a 10Mg of Oxy, it's 8 or instead of a 40Mg of Oxy, it's 32. And, to me, what's very concerning, is that bigger the dose you're on, the bigger the variance.....20% of a bigger number is a bigger number!! Just imagine those who are on 200Mg of Oxy per day...It can be as low as 160 (.8 of 200).
Ex
Also take into consideration each person's weight, tolerance, ect. The fact that EACH person is written a script to take the SAME WAY!
1 every 4-6 hrs...that person can weigh 200 lbs, and the other person gets the SAME instructions and weighs 120 lbs.
The whole system is screwed up if you ask me....sorry, its probably a whole new subject~
We can all live with small, normal variation. The thing with generics, however, is that they are allowed to be -20% variation....This is what causes the problems. Instead of a 10Mg of Oxy, it's 8 or instead of a 40Mg of Oxy, it's 32. And, to me, what's very concerning, is that bigger the dose you're on, the bigger the variance.....20% of a bigger number is a bigger number!! Just imagine those who are on 200Mg of Oxy per day...It can be as low as 160 (.8 of 200).
Ex
Also take into consideration each person's weight, tolerance, ect. The fact that EACH person is written a script to take the SAME WAY!
1 every 4-6 hrs...that person can weigh 200 lbs, and the other person gets the SAME instructions and weighs 120 lbs.
The whole system is screwed up if you ask me....sorry, its probably a whole new subject~
HappyFlower
04-11-2008, 11:19 PM
Thank you for the info...I will take the advice...what does "DAW" on a script mean??
As I was heading to sleepy land last night, I happened to come across a question in my head that I am still hung up on...
Why, why are ANY of the drug companies allowed to have a +/-20?? I mean, why should they not be held to the standard that if the bottle says there is 7.5 of hydro and 500 of tylenol....then that is how much should be in there, period????
We sure don't have a +/- in the amount we pay for the meds...
As I was heading to sleepy land last night, I happened to come across a question in my head that I am still hung up on...
Why, why are ANY of the drug companies allowed to have a +/-20?? I mean, why should they not be held to the standard that if the bottle says there is 7.5 of hydro and 500 of tylenol....then that is how much should be in there, period????
We sure don't have a +/- in the amount we pay for the meds...
brianpain33
04-11-2008, 11:21 PM
DAW - dispense as written
brian
brian
Executor
04-11-2008, 11:23 PM
Also take into consideration each person's weight, tolerance, ect. The fact that EACH person is written a script to take the SAME WAY!
1 every 4-6 hrs...that person can weigh 200 lbs, and the other person gets the SAME instructions and weighs 120 lbs.
The whole system is screwed up if you ask me....sorry, its probably a whole new subject~
Great point Izz....I'm willing to bet that very few Docs actually factor weight (or sex) into the equation. To your point, I find it highly unlikely that a "typical woman" needs as much med as a "typical male" despite the 40-60 pound wt difference.
Ex
1 every 4-6 hrs...that person can weigh 200 lbs, and the other person gets the SAME instructions and weighs 120 lbs.
The whole system is screwed up if you ask me....sorry, its probably a whole new subject~
Great point Izz....I'm willing to bet that very few Docs actually factor weight (or sex) into the equation. To your point, I find it highly unlikely that a "typical woman" needs as much med as a "typical male" despite the 40-60 pound wt difference.
Ex
Executor
04-11-2008, 11:30 PM
Why, why are ANY of the drug companies allowed to have a +/-20?? I mean, why should they not be held to the standard that if the bottle says there is 7.5 of hydro and 500 of tylenol....then that is how much should be in there, period????
Because the law says they don't have to. You have to remember that politicians are influenced by lobbyists. Additionally, there has been lots of talk about the federal appointees to the FDA. These appointees make the recommendations, and unfortunately, many have ties to big drug companies.
Candidly, a company isn't going to incur extra cost to make their generic equal when they don't have to...They're going to use every loophole they can to be more profitable. Just like when you do your taxes, if you get a personal exemption or special deduction, you're probably going to take it....Rather than voluntarily pay more taxes to reduce the deficit.
I just wish that they wouldn't mislead everyone by saying generics are "equivalent" to the brands, because they are not. GMCs are equivalent to Chevy because it's made in the same factory, by the same company, with the same engine, and the same parts, accessories, & etc. The name is just different due to branding strategies. However, if you changed the GMC by 20%, it's no longer equivalent. IMO, the whole thing is a scam and the consumer is being de-frauded and misled.
Hope this makes sense.
Ex
Because the law says they don't have to. You have to remember that politicians are influenced by lobbyists. Additionally, there has been lots of talk about the federal appointees to the FDA. These appointees make the recommendations, and unfortunately, many have ties to big drug companies.
Candidly, a company isn't going to incur extra cost to make their generic equal when they don't have to...They're going to use every loophole they can to be more profitable. Just like when you do your taxes, if you get a personal exemption or special deduction, you're probably going to take it....Rather than voluntarily pay more taxes to reduce the deficit.
I just wish that they wouldn't mislead everyone by saying generics are "equivalent" to the brands, because they are not. GMCs are equivalent to Chevy because it's made in the same factory, by the same company, with the same engine, and the same parts, accessories, & etc. The name is just different due to branding strategies. However, if you changed the GMC by 20%, it's no longer equivalent. IMO, the whole thing is a scam and the consumer is being de-frauded and misled.
Hope this makes sense.
Ex
HappyFlower
04-12-2008, 01:47 AM
yes Ex, it makes sense..thanks for reminding me about the oh-so-honest polititians..lol
I was just trying to make a point..that if something says it has a certain amount on the label...that amount should be in there. The compaines, whether producing brand or generic, should be required to put the printed amount IN the pill. We are dealing with medicine here...not green beans! Who cares if my grean beans are off by 20%!!! But with medicine, too much or too little can mean life or death to some.
If they want to cut corners..then they should be required to list it as hydrocodone APA 6.7/487 rather than hydrocodone APA 7.5/500!!!
I don't understand what would be so hard about making the companies put the "advertised" amount of medication in the actual pill/patch..or whatever.
What gives them the right to short change us? We are purchasing their product under the assumption that the prescribed amount of medication is in the freaking pill.
That is a stupid law. I'll bet all those politicians would be miffed if their Viagra were off by 20%....
I was just trying to make a point..that if something says it has a certain amount on the label...that amount should be in there. The compaines, whether producing brand or generic, should be required to put the printed amount IN the pill. We are dealing with medicine here...not green beans! Who cares if my grean beans are off by 20%!!! But with medicine, too much or too little can mean life or death to some.
If they want to cut corners..then they should be required to list it as hydrocodone APA 6.7/487 rather than hydrocodone APA 7.5/500!!!
I don't understand what would be so hard about making the companies put the "advertised" amount of medication in the actual pill/patch..or whatever.
What gives them the right to short change us? We are purchasing their product under the assumption that the prescribed amount of medication is in the freaking pill.
That is a stupid law. I'll bet all those politicians would be miffed if their Viagra were off by 20%....
Executor
04-12-2008, 10:08 AM
Happy....I couldn't agree with you more. In one of my posts in this thread, I make the exact same point....We're paying for something that we're not getting.
Again, it's politicians & FDA people looking after big pharmaceutical companies and not the general public. Did you see Shoreline's post about the Methadose? Very telling!
Thanks.
Ex
Again, it's politicians & FDA people looking after big pharmaceutical companies and not the general public. Did you see Shoreline's post about the Methadose? Very telling!
Thanks.
Ex
feelbad
04-12-2008, 12:25 PM
another actual "loss' of the active med actually takes place during the metabolization process where part of the "active' ingredient gets destroyed in just trying to metab and release it.you would think this part would be taken into acct since it just occurs naturally in the way the metab process goes. but of course they dont. even with brand name meds,you never are going to get what it actually staes on the Rx it actually gives you.
but the whole(FDA/drug co)system is very sick overall and does need some massive changing.marcia
but the whole(FDA/drug co)system is very sick overall and does need some massive changing.marcia
HappyFlower
04-12-2008, 03:13 PM
you are right, feelbad...very good point. I suppose the only thing would be we all metabolize the meds differently...so it would be next to impossible for the companies to find a formulation which allows exact amounts metabolized once the pill enters the digestive tract.
However, they CAN control how much is in there to start with!
Ex, I went back and read Shoreline's entry..it was very telling. I am ashamed to admit there are times when I come in on the tail end of a long thread and I don't read the entire thing or just "skim" it...that is a very bad habit, I know. Sorry!!
However, they CAN control how much is in there to start with!
Ex, I went back and read Shoreline's entry..it was very telling. I am ashamed to admit there are times when I come in on the tail end of a long thread and I don't read the entire thing or just "skim" it...that is a very bad habit, I know. Sorry!!
forginon
04-12-2008, 04:03 PM
another actual "loss' of the active med actually takes place during the metabolization process where part of the "active' ingredient gets destroyed in just trying to metab and release it.you would think this part would be taken into acct since it just occurs naturally in the way the metab process goes. but of course they dont. even with brand name meds,you never are going to get what it actually staes on the Rx it actually gives you...
However, the metabolization process is critical to the whole pain relief mechanism.
If it weren't for the active ingredient(s) getting metabolized many of us would be in sad shape. Quite often, it's the metabolites that deliver the actual pain killing power. There are loads of examples. Morphine is metabolized into M3 and M6 metabolites, and one of them is both active and much more potent than the morphine itself. Tramadol is metabolized into M1 and another metabolite, delivering the real analgesia. If it weren't for the metabolism we wouldn't even get the pain killing effect at all.
Each of us individually possess different anatomical qualities in how our organs, specifically the liver, behaves. You may be a super-metabolizer, which would be very unfortunate, since you would be losing much of the analgesic quality of your meds. I, on the other hand, may not be able to metabolize well at all, making me a prime candidate for an overdose. Then there's the other drugs we take. Some of them, like the SSRIs, can have a detrimental effect on metabolism, causing our meds to be either more or less potent depending on the particular medication.
This is so complex. But the bottom line, as Marcia, Ex and others have pointed out, is that if the generic or the brand drug have such wide variability in what they're allowed to actually put into a pill, then who knows what we're getting? We do, eventually, when we either get the pain killing effect, or go into withdrawal, but by then it's too late.
This is really sad.
steve
However, the metabolization process is critical to the whole pain relief mechanism.
If it weren't for the active ingredient(s) getting metabolized many of us would be in sad shape. Quite often, it's the metabolites that deliver the actual pain killing power. There are loads of examples. Morphine is metabolized into M3 and M6 metabolites, and one of them is both active and much more potent than the morphine itself. Tramadol is metabolized into M1 and another metabolite, delivering the real analgesia. If it weren't for the metabolism we wouldn't even get the pain killing effect at all.
Each of us individually possess different anatomical qualities in how our organs, specifically the liver, behaves. You may be a super-metabolizer, which would be very unfortunate, since you would be losing much of the analgesic quality of your meds. I, on the other hand, may not be able to metabolize well at all, making me a prime candidate for an overdose. Then there's the other drugs we take. Some of them, like the SSRIs, can have a detrimental effect on metabolism, causing our meds to be either more or less potent depending on the particular medication.
This is so complex. But the bottom line, as Marcia, Ex and others have pointed out, is that if the generic or the brand drug have such wide variability in what they're allowed to actually put into a pill, then who knows what we're getting? We do, eventually, when we either get the pain killing effect, or go into withdrawal, but by then it's too late.
This is really sad.
steve
Executor
04-12-2008, 09:08 PM
Yes.....Feel, Happy, & Steve....Your metabolism discussion is right on cue. And, when you start with approximately 20% less of the med, it's that much more of an issue, IMO.
Ex
Ex
forginon
04-12-2008, 11:35 PM
Totally agree.
For one who is a super-metabolizer it could mean getting zero measurable medication.
Yuck!
steve
For one who is a super-metabolizer it could mean getting zero measurable medication.
Yuck!
steve
HappyFlower
04-13-2008, 01:46 AM
wow..ya'll are starting to use big words and all..getting over my head..lol!!
badexampleJen2
03-17-2009, 05:33 PM
great thread! thanks for all the research. When I was very severly ill, my doctor told me that I needed brand name meds only and that my life depended on it. Back then my insurance paid for them when the doc wrote DAW and medically necessary but not anymore. I am on disability and am on one of those Medicare drug programs and also have Medicaid. Medicaid doesn't pay for drugs anymore, and the Medicare program will absolutley not pay for brand. Right now my health is stable, so I am not in danger by taking generics, but I am not getting the optimal pain relief from my pain meds at this point.
Executor
03-17-2009, 11:18 PM
great thread! thanks for all the research.
Yes, it is a good information. The key here is that according to the Hatch-Waxman Act, Congress permits 20% variation in order to keep costs reasonable because they feel that med provides the same "therapuetic" level. That may be true for allergy meds, or some other type of remedial issue....But not pain. I have two big issues with this policy, as it relates to pain......
(1) -20% is more than enough to cause WD, and in fact, can have a major impact on one's condition and the associated pain...And thus, quality of life.
(2) I don't like being misled and told that xyz generic is the "same" med. It's not. I don't know why they just can't be honest, put the information out there in a positive manner, and let the consumer decide. All they have to say is something like "xyz has less of the active ingredient but many studies have shown that you may get basically the same therapuetic effect.....And of course the cost is significantly less." Then, let the consumer decide on which to purchase based on truth and labeling.
Not only are brands more stable, lot to lot, but also pill to pill. They also have better inactive ingredients (fillers) and tend to be more effective all the way around. In many cases, however, generics do just fine. Let the consumer decide, but give them accurate information. It's no different than when we go to the grocery store and buy off brand Ketchup (random example)....It might not taste as good as Heinz, but does just fine and fulfills the need satisfactorily. However, for those who want the best ketchup, they purchase brand. They aren't sold generic ketchup in a Heniz bottle.
Regards,
Ex
Yes, it is a good information. The key here is that according to the Hatch-Waxman Act, Congress permits 20% variation in order to keep costs reasonable because they feel that med provides the same "therapuetic" level. That may be true for allergy meds, or some other type of remedial issue....But not pain. I have two big issues with this policy, as it relates to pain......
(1) -20% is more than enough to cause WD, and in fact, can have a major impact on one's condition and the associated pain...And thus, quality of life.
(2) I don't like being misled and told that xyz generic is the "same" med. It's not. I don't know why they just can't be honest, put the information out there in a positive manner, and let the consumer decide. All they have to say is something like "xyz has less of the active ingredient but many studies have shown that you may get basically the same therapuetic effect.....And of course the cost is significantly less." Then, let the consumer decide on which to purchase based on truth and labeling.
Not only are brands more stable, lot to lot, but also pill to pill. They also have better inactive ingredients (fillers) and tend to be more effective all the way around. In many cases, however, generics do just fine. Let the consumer decide, but give them accurate information. It's no different than when we go to the grocery store and buy off brand Ketchup (random example)....It might not taste as good as Heinz, but does just fine and fulfills the need satisfactorily. However, for those who want the best ketchup, they purchase brand. They aren't sold generic ketchup in a Heniz bottle.
Regards,
Ex