E-drug: Generic substitution (cont'd)
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I have heard pharmacists arguing over and over about bioequivalency
tests of generic and brand name drug products, offering unfounded
professional knowledge to promote costly medications. To date a well
documented therapeutic inequivalence between the two products has
not been proven.
Bioavailability problem in drugs with narrow therapeutic index have
been reported with both generic and brand name drugs and it mainly
related to an inherent problem with the drug's chemical characters. A
perfect example is carbamazepam.
Drugs with narrow therapeutic window, such as warfarin or
carbamazepam, are monitored routinely and when a switch is made
to save money, doses can be easily are adjusted - if at all. The cost
of health care is getting so bad and yet someone is trying to make the
already existing problem even worse. Please refer to the Medical
Letter October 14, 2002 for more information on this topic.
Sana R. Sukkari
Oncology/Palliative Care Pharmacist
Joseph Brant Memorial Hospital
Burlington ON
Canada
e-mail: ukkari<ssukkari@jbmh.com
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