One Reason to Not Use Generic Medicines

Our latest podcast episode — “How to Save $1 Billion Without Even Trying” — discusses research which finds that health-care experts generally buy generic medicines for their own use rather than the more expensive name brands. The episode discusses the various reasons that brand names might be more appealing despite the higher cost. A listener named Mike Dimore has written in with an interesting, and serious, reason that didn’t come up:

This won’t apply to many people but for the few that it does apply to (myself included), it can end up costing them hundreds of thousands of dollars. I was diagnosed with ulcerative coilitis after taking an acne medication called Accutane. I had a lawsuit against the company that manufactured the drug, but since it was a generic version the company had no liability. They offered me a $8,000 settlement but I refused. My case was dismissed after the Supreme Court decision for Mutual Pharmaceutical Co. v. Bartlett, which essentially made it impossible for a consumer to sue a generic drug company. The people who took the non-generic version of this drug however received significantly higher settlement offers ($100k+).
This is a very specific and unfortunate example of why brand name can be better, but if and when it does happen it becomes a very significant one.


Pal

An incredibly American incentive to switch back to non-generics, that's for sure. The odds seem as bad as playing the lottery, but at least you have something to show for the extra money you put in (i.e., your health, hopefully).

Eric R

From howstuffworks.ocm:
" In the United States, an average drug patent lasts for 17 years. Once the patent expires, other companies can produce generic versions."

So what was wrong with the medication that wasn't figured out long before the patent ran out?

algkh

Usually, half of those years are spent in testing in labs.

Ian Woollard

Of course this backfired, because it led Hoffmann-La Roche to stop manufacturing the drug.

Also, if you're not in a country with a crazy health system, then it doesn't matter anyway, because your health needs are covered anyway.

Chris Mikaitis

I'm not sure I see the problem here. The whole point of the FDA is to mitigate this sort of risk. If you choose to sidestep this process, you take the risk for yourself.

I'm not saying this from some ivory tower. I order my prescription drugs through online pharmacies as well. I also understand that I have no recourse if these same drugs are ineffective or even harmful. It sounds like the drug supplier, in this case, did nothing wrong. They supplied the drugs as advertised. The fact that there were harmful side effects is a risk everyone who takes prescription drugs must face. Do you receive the newest medication, or wait for it to be vetted. I don't know how suing is the answer to either issue.

OS

Suing at least provides some coverage of the medical and other expenses created by the harmful drug. The company usually makes a profit off of the drug, especially while it has patent protection. Part o that profit can be used to help consumers hurt by the drug.

Richard Williams

According to a story yesterday on "Science Friday" on NPR (Jeremy A. Greene's new book "Generic: The Unbranding of Modern Medicine") there has been a court-approved and unsuccessfully appealed lawsuit against the original maker of the patented drug when the patient was harmed.

The legal theory is that the generic manufacturer was only required (and only marketed) the generic as being the same biological effect (dose, purity, metabolism) as the patented brand-named drug. The advertising and "bragging rights" for the original drug (its "claims to fame") were all under the auspices of the inventor/patentee of the drug. Hence, the inducement to prescribe as a curative and success (or failure) of treatment were all part of the original marketing/testing and therefore liable.

Lizabeth

Something to consider about where professors send their kids to college - don't you have to take into consideration that most get a discount on tutition where they work? I would think that would influence where their kids go.

scientistbymistake

Interesting story, but I have a fundamental problem with this: the cause(s) of Ulcerative Colitis (and other inflammatory bowel disease) have not been identified.
How anyone got any kind of legal settlement based on correlation/coincidence with no evidence of causality baffles me. It's not just the healthcare system that's crazy!!

Oliver H

Yes, it's you, too.

http://www.ncbi.nlm.nih.gov/pubmed/?term=isotretinoin+bowel

JB

But in the list you helpfully provide is an article that questions the correlation:

Am J Gastroenterol. 2014 Apr;109(4):570-1. doi: 10.1038/ajg.2014.34.
Isotretinoin and inflammatory bowel disease: trial lawyer misuse of science and FDA warnings.
Tenner S.

Abstract: Based on the Food and Drug Administration Adverse Event Reporting System (FAERS), the FDA and Hoffman La Roche issued warnings of a possible causal association between isotretinoin and inflammatory bowel disease. While scientists studied the association, trial lawyers used the courts to award large sums of money to plaintiffs despite the absence of clear scientific evidence of a causal effect. In this Issue of the Journal, a well-designed, large pharmaco-epidemiologic study shows no association. The story of isotretinoin highlights the problems that occur when the FAERS is used in litigation prior to further study and scientific analysis.

Read more...

SocioEpidemiologist

Because the show focused on the'generic purchasing' behavior of topic-specific highly-educated people, the 'suing inequality' between store & national brands should have at least being mentioned as a perplexing factor--or evidence that few (even experts) are unaware that store brands have a small liability.

meanonsunday

It's misleading to say that the generic company has no liability as that is not what the Supreme Court decided. They have liability under federal law, but they cannot be liable under state laws that conflict with federal law.

Of course the lawyers who try such cases greatly favor state courts that are more easily manipulated.

GB

I am a professor at a land-grant, public (US) university, had my undergraduate education at a large public school and my graduate education at an ivy league university. I would never send my child nor recommend a private university for education because I believe that education should be available and affordable to all. I am sure I am not the only one who has ideals that would not choose individual benefit to the detriment of society. Private institutions degrade public ones when those with the most influence no longer have a stake in the public system.

Peter Dillinger

I often end up buying name brand drugs simply because in more cases they offer formulations without allergens in their inactive ingredients. I am allergic to corn, so I have to avoid pills with corn starch or cellulose. Liqugels, reditabs, or syrups are more typically safe for me and are often only available from name brands.