In class last week we discussed brand and generic prescription medications and the pharmaceutical industry in general, and how they profit from our health. Since I’m in close contact with prescriptions every day and (unfortunately) deal with insurance companies just as often, there are a few things I found interesting as we spoke about the pharmaceutical company in class.
One day at work I was changing a prescription to brand name Lipitor rather than its generic equivalent atorvastatin, and when I brought it to my pharmacist to verify, he told me that Pfizer, the drug manufacturer of Lipitor, also makes the generic equivalent atorvastatin. This isn’t constant with all drugs and manufacturers or even in all pharmacies, but at my store, we get the brand and generic from the same drug manufacturer, meaning that they are made on the same line out of the same inactive ingredients.
There has also been a lot of discussion about the massive price increase of the EpiPen. Interestingly enough, there are a few alternatives, but they are not considered bioequivalent by the FDA, making it so pharmacies can not substitute the generic or alternative epinephrine auto-injectors for the brand name EpiPen. Essentially, if your doctor writes for EpiPen, we have to fill EpiPen at the pharmacy, and in order to change it to an alternative, we have to get a whole new prescription from the doctor. I do not understand why pharmaceutical companies choose to monopolize life-saving drugs like epinephrine. With auto-injectable epinephrine, the drug itself is very cheap, and the differences between the brands are in the injector itself. This makes switching between brands confusing for patients who have been using the same type of auto-injector for years. With such an important, life-saving medication, it is significant that you understand how to use which one you receive.
Lastly, something that I found interesting about brand versus generic medications was the price fluctuation immediately after releasing a new generic. Take Crestor (rosuvastatin) for example. Just a couple months ago, AstraZenica’s, the manufacturer of brand-name Crestor, patent ran up and other drug companies began making their own bioequivalent versions. When you hear brand versus generic, you assume the generic will end up cheaper, right? Well, sometimes drug manufacturers will do all that they can to keep consumers from using their product rather than the new approved generic. Crestor has several coupon cards for free trials and co-pay savings. A lot of patients at my pharmacy who had been paying approximately $10-$20 for brand name Crestor were suddenly expected to pay almost $300 for the generic. (At pharmacies, we are legally required to dispense the equivalent available generic unless the doctor or patient requests otherwise.)
All in all, it is ridiculous that the pharmaceutical companies are competing with one another to get their product used, all while causing the population to suffer. With something as important as healthcare, you would expect that your best interests would be looked out for, but as we are learning in class, unfortunately that is rarely the case anymore.