E-DRUG:Medical doctors & belief in brand names (6)
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The utility or foolishness of brand names in prescribing has been debated
since the 1950s, at least in the U.S, Many products have brand names of
course, and those names help distinguish one product from another quite
specifically. Thus we may set out to buy a television (generic) and because of what we've heard or experienced about a particular firm, we may give one trademark (SONY) the inside track. Of course our final choice is likely to involved a review of various where the drug lobby had pushed through legislation, state after state, requiring every Rx for, say, Pentids be filled with the Squibb name. At the time, it seemed that the laws were mostly anticompetitive in effect, through there were the occasional reports of grungy garage laboratories where those shadowy generics emerged almost like counter band rum brought in by speedboats from Noriega-land.
prohibiting pharmacists filling a scrip for "Darvon" provide rospoxhemine.
At the time, For me, reliance on generic terminology by prescribers requires an assumption that every formulation of the needed drug is interchangeable with every other. That assumption requires a massive leap of faith in a world where the existence of uniform cross-national good manufacturing practices are far from certain. Add the increased incidence of flat-out counterfeiting, and confidence that every formulation of, say, amoxicillin, is the equal of all others requires a level of faith I'm not willing to grant.
James B. Russo
146 Koenig Rd.
Bernville, PA 19506
USA
jbrusso@aol.com
610 488 9060
484 269 6470 (mobile)
E-DRUG: Medical doctors & belief in brand names (8)
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Dear all
It would be interesting in this discussion to have the views of a medical
sociologist.
In the Netherlands the government urged us to switch to generic prescribing
a couple of years ago, and in the pharmacy where I now work, approx. 90% of
the prescriptions mentions the generic name. When available, that is what we dispense. When not available, we dispense the branded drug (and only if that is available, because a number of branded drugs now has a limited
availability, due to commercial considerations from the part of the
pharmaceutical industry). So somehow, Dutch doctors became convinced that
generics are as good as the branded equivalents. However, there are two
important considerations.
- We have no reports of counterfeit in the Netherlands; (almost) all
pharmacists buy at regular and certified wholesalers.
- The 'power' of industry to give medical practitioners (doctors and
pharmacists) a treat has been limited over the last years in the EU. No free lunches or 'educational' trips to the Carribian anymore.
So far the Dutch experience,
Foppe
E-DRUG: Branded generics and INNs
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Dear all
Generic products are often branded and sold under fancy names, so we¹d
better talk about International Nonproprietary Names (INNs).
There is campaign launched by Medicines in Europe Forum that promotes the
use of INNs by healthcare professionals and the public, with Information
material explaining the advantages of using INNs at
http://www.prescrire.org/cahiers/dossierDciLeaflets.php
The ISDB Newsletter November 2006 is entirely dedicated to the INN issue.
http://66.71.191.169/isdbweb/pag/newsletter.php
or on WHO/INN program website at
http://www.who.int/medicines/services/inn/en/
Christophe Kopp
Staff editor with la revue Prescrire
ISDB Secretary
ckopp@prescrire.org
E-DRUG: Medical doctors & belief in brand names (10)
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Dear colleagues,
This is an interesting discussion which goes back a number of years. The fact that we discuss it today shows that little has been achieved in changing the attitude, behaviour and positions in this respect. One or two things can be done to change the 'belief'. For example, education can be used as an avenue to address the 'belief': the difference between 'patent product' and a 'generic product' needs to be addressed objectively, and the education process can help in that. Another approach is health policy. At the end of the day, a doctor is not an independent unit who can decide what to provide to a patient (of course in the very long past that was the case!). There is national guidance in that process. Many countries suffer from a lack of clear policy on pharmaceutical products, specifically in the use of brands and generics (the Netherlands' decision is a case in point).
There may be 'National Formulary' committee or similar bodies, but an assessment of their guidelines often shows no reference to a national position on patents and generics. It is often left to pharmacists in the system to advocate one way or the other. Once that can be addressed objectively, practitioners (prescribers and pharmacists alike) will be properly guided in addressing and using forms of pharmaceutical products. In Zambia, we are following that approach.
Regards,
Bonface Fundafunda
Drug Supply Budget Liine,
Ministry of Health,
Lusaka,
Zambia
bcfunda@hotmail.com