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 “Generic medications are cheaper and patients are more likely to get
those prescriptions filled,” said Dr. Amir Qaseem of the American
College of Physicians, who coauthored the recommendation.
“This is for both physicians and patients,” Qaseem told Reuters
Health by phone.
Despite what some patients and even doctors may believe, generics
are consistently as effective and safe as their brand-name
counterparts, he said.
The ACP reviewed existing evidence and found that for Medicare
beneficiaries with diabetes, for example, up to 45 percent of
prescriptions are for brand-name drugs when identical generics are
available. Choosing these generics instead, and choosing
therapeutically similar but chemically different generics in some
other cases, could save up to $1.4 billion for Medicare, the
reviewers found.
Brand name prescriptions are almost twice as likely to be prescribed
but never picked up from the pharmacy than generics, and not
adhering to prescribed medications leads to higher out-of-pocket
costs for patients later on, the reviewers wrote in the Annals of
Internal Medicine.
“Often, patients don't tell their doctors they can't afford an
expensive drug they were prescribed; they just fail to take it, or
take it at sub-therapeutic (too low) doses because of its cost,”
said Dr. Jerome Avorn, professor of medicine at Harvard Medical
School in Boston, who was not part of the new study. “And this has
major health effects.”
“Logically it might feel like people should already be using
(generics), but that’s not the case,” Qaseem said.
The new recommendation “is based on a thorough review of data from a
huge number of relevant studies in the medical literature, raising
it above the level of 'conventional wisdom,'” Avorn said.
The American College of Physicians is one of the most widely
respected bodies in medicine, Avorn told Reuters Health by email.
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Some physicians may not be aware that a generic form of a medication
is available, or may refer to the drug by its brand name out of
habit, which results in more expensive prescriptions, Qaseem said.
Continuing physician education programs could keep doctors abreast
of available generics, as well as interactive options on electronic
health records, he said.
“A large scale public awareness campaign is what’s needed,” he said.
“Many think if it’s cheaper it’s not as good.”
But, there are some cases when a generic substitution is not
available or is not appropriate for a particular patient, he noted.
“This information about generics is especially timely now, given all
we've seen in the last year or two demonstrating that brand-name
companies can charge whatever they please for their products, even
if the price is astronomical,” Avorn said. “It's not clear that will
change any time soon, making it even more important to educate
doctors to use generics whenever possible.”
SOURCE: http://bit.ly/1i46lF7 Annals of Internal Medicine, online
November 23, 2015.
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