generic drugs

[baloo]

I've been fighting some nasty infection for a while now and Ciprobay has become my best friend.

In Aus I needed to get some and I was given the generic instead of the branded stuff I get here and I was shocked at the price difference.

I just picked up a prescription for another 30day course and decided to hunt down generic ciproflaxin in Singapore. It's not easy to find but I tracked it down and it was worth it.

Price comnparison:

Ciprobay 500: $9.84 per tablet
Ciproflaxin 500: $0.24 per tablet.

It's just a shame the only places in Singapore that sell the Generic are public hospitals.

[Fat Bob]

Yes, generics are available in Singapore but it's difficult to find them. Some doctors will have them, some won't. That's the big issue: the doctor will sell you what he's got in his surgery pharmacy, and only if you need a drug he doesn't have, will he give you a scrip for a pharmacy - and then you have tto shop around for a pharmacy that sells that drug!

Can I ask how you came about the knowledge for Singapore? Is there an online price checker? Or do you have to email around?

[Kooky]

IME chemists here usually offer you the generic brand first. Unfortunately most of what I use is specialist, compounded, and not covered by Medicare.

[baloo]

Yes, generics are available in Singapore but it's difficult to find them. Some doctors will have them, some won't. That's the big issue: the doctor will sell you what he's got in his surgery pharmacy, and only if you need a drug he doesn't have, will he give you a scrip for a pharmacy - and then you have to go to a public hospital!

Can I ask how you came about the knowledge for Singapore? Is there an online price checker? Or do you have to email around?

My Dr was happy to give me a prescription when I asked for generics.

The price was easy, I asked the Public hospital pharmacy when I called them to check if they had them. They gave me the two different prices over the phone.

In Aus I was given generics without even being asked, but I have been asked in the past.

[Fat Bob]

In the UK it used to be that if the doctor writes the trade name on the prescription, the pharmacy had to give you the trade named drug. If the doc wrote the generic then the pharmacy could give you either. However, if the prescription was an NHS prescription, then the pharmacy had to give you the cheapest. Work all that out!

[daffodil]

Question for FB - are generics available for most drugs or just a certain type of medicine? I'm thinking specifically for migraine treatment which is very expensive.

[Fat Bob]

All depends how old the drug is and whether a 3rd party can manufacture it more chepaly.

All compounds have a 20 year patent protection (once patented). However, that date starts from the day you file the patent, not the day the drug gets to market. Most drug companies will "file early" in the lifetime of the compound to make sure another company doesn't get there first. It will take somewhere between 8-12 years to finish off all the work to make sure the compound is effective, has a reasonable safety profile and whether it can be used across a whole area of disease or just in certain sub-populations of patients.

The second thing is secondary patents: for instance, a drug company could patent a new, cheaper way of making a drug. This could mean that, though others can produce the drug after the compound is "off-patent", they may not be able to use the new method of making it which would make it cheap enough to make.

Finally, there's simple economics: if a generic company can make it cheaper, and there is enough demand, then there will be at least one generic. For instance, the amoxicillin/clavulanic acid combination antibiotic has about 26 different companies that make it. The company that originally discovered the combination (Beechams, now GSK) still produces it as Augmentin, and still sells enough that it's worthwhile to produce. Coupled with brand name recognition, then there are still markets for old drugs fromt he original manufacturers.

If you look at major drug companies in the financial press, there are a lot of concerns about "patent expiry" and "pipeline". I saw a presentation that, within 6-12 months of a compound going off patent, the drop for a mildly successful drug in sales can be as high as 90% as generics come in. The pipeline is what new drugs are coming in order to continue the high sales.

Feel free to drop me an PM with the name of the drug and I'll have a quick squiz for you.

[baloo]

Drooping the price to make generics less appealing isn't an option ?

If the price difference for me was about 20% wouldn't waste time chasing a generice. But when it's 40x more expensive, I'll chase generics.

[Fat Bob]

In your example the generic is 2-3% of the price of the original.

Drug companies play a fine line between making profits and providing drugs which are, to some people, a human right (and therefore should not be profited off).

The drug company itself is under a lot of pressure from governments who pay for healthcare to have the lowest price even when on patent. Dropping it any further is difficult so as to not make it worthwhile to continue to manufacture it, as the profits not only go into the pockets of the fat cats and shareholders, but also into developing new drugs, which ain't cheap!

[Rosbif71]

Doctors should not be allowed to dispense drugs. They make a profit from it and therefore some will be encouraged to prescribe drugs that are not needed or prescribe expensive brand drugs that will give them more profit.

[Tas]

One thing that I ponder on is delivery mechanism for some branded products vs generics - that something you can speak to Bob? Eg I've tried brand vs generic for a couple topicals, and I have got to say, the absorption and effectiveness of the branded one was about 200% on the generic one despite the % content active component being same. Which got me pondering on slow release tablets vs fast uptake vs capsules with granules vs capsule coating (have mates that work in the development of granulation and processes for manufacture of pharmaceuticals which got me thinking on distributions of active compounds) which all forms part of the delivery of the compound and effectiveness so I often err on side of the brand when given choice even now with the cost element...

[Fat Bob]

Agree, Rosbif. Though I've an inherent belief that the doc would always look for the best for you, they are obvious conflicts when they have only one of the two or more possible drugs that could be used.

Good question, Tas. I think one thing you have to check is the quality specs of the branded versus generic. I don't know what these specifications are, but I doubt very much that you are receiving exactly 500mg of paracetamol in every pill that suggests you do. How close to 500mg is the question you have to ask, and I'm guessing that different companies have different specs. That could be the first part of "which one is more effective?" question, i.e. are you receiving the full dose?

The second thing is, as you rightly point out, are you getting the same formulation (i.e. what else is in the pill/cream/solution), the exact same type of pill (coatings etc) and the same isoform of compound (it's a known fact that some isoforms of the same compound are active whilst others aren't. Same compound, different crystal structure etc.). The generics should have to go through some sort of testing to make sure they are as effective as the original, but I'm unclear if that happens and how it happens.

[avatarless]

I assume importation through mail is banned? There are a couple of reliable NZ pharmacies that sell generics.

[Fat Bob]

I don't think it is banned: in the past I've had prescription drugs sent through the mail from UK to Singapore.

[slinky]

I don't think it is banned: in the past I've had prescription drugs sent through the mail from UK to Singapore.

I'll bet it depends on how the package is marked. The HSA confiscated prescription contact lenses I ordered back in August from 1-800-Contacts in the US. They eventually released them to me, but apparently they are cracking down on contact lenses coming in privately due to bad or counterfeit ones that were damaging people's eyes or something. I basically had to sign off and personally agree to it being solely my problem if anything went wrong in order to collect them. In all honesty, they probably released them to me because I am not a citizen and not part of their national health plan anyway - which is fine by me given I've ordered lenses from this company for years and I trust they are the real deal. Moral to the story is, I wouldn't count on being able to receive prescription anything in the mail here anymore.

[ereola]

i have been using generic drugs for quite sometime now and i am really saving a lot of money but then it really depends on how well yo are able to really find reliable soures because nowadays placebo or fake drugs are also very rampant in the market due to black market trading so this is something that you should be on the watch for as they may pose as cheaper drugs on the market and mistaken for a generic brand. it is best that you d check a real store as online drugs are the usual market for these fake drugs.