Are Generic And Brand Medication The Same? Maybe

Brand and Generic Medication

There is a general confusion especially among patients concerning generic and brand name of drugs. The confusion is not very common in hospital pharmacy. This is more pronounced when you come to the community pharmacy.
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Medical doctors prescription of drug is influence by a couple of factors. But when every other factor is constant, some write drugs based on their generic name, brand name or active ingredient. There have been strong debate all around the world as to which is better for the benefit of both health care professionals and the patient. Lets us look at each prescription.

Prescription

When a doctor writes out a prescription using the name of the active ingredient, the pharmacist can use his discretion and dispense any product that contains same strength and active of that drug. E.g. metronidazole. There are cases an active will have more than one manufacturer such as brand and generic. E.g. flagyl and emgyl contain same active (metronidazole) but from  different manufacturers. On the other hand, in a situation where the name of a brand or generic is use, the pharmacist can face difficulty with the patient trying to give an alternative. E.g. writing flagyl and emgyl. They may fear it is either a different active or of lower efficacy. But many patients hardly complain if it happens in the hospital pharmacy because they trust their judgement. The whole scenario is different in a community pharmacy. Many patients are of the opinion that the community pharmacy is all out there for profit hence won't mind if the alternative drug does harm. Is that fear worth it?
There are conditions guiding writing prescription. But before we go deeper, let us look at each term and their meaning.

Generic And Brand

A brand drug is a drug that is manufactured by the parent company to have discovered it and retain the patent right. They can produce this drug for years without competition from other manufacturers. When the patent expires, other companies who wish to manufacture that active can then come in. So because of the years and money spent during research and discovery, the cost of markup is usually high enough to recoup all expenses before the patent expires and after. That is why brand drugs tend to cost more than their generics.
Generic drug only copy the brand drug. In this case, no research is required before it will be approve. The only thing National Agency For Food and Drugs Administration and Control (NAFDAC) look at is the quality standard operating procedures. Because of the lower production cost, the final product is more cheap than the brand drug even though they have thesame active ingredient. The dosage, safety, effectiveness, strength, stability and quality is thesame. The only difference maybe the difference in some non important excipient which is not suppose to alter the efficacy of the product. This include shape, colour, packaging, labeling which are the only difference that is suppose to happen in a generic drug. Some excipients make the price of brands go up. Some of these excipients can actually enhance the bioavailability of drugs.
There is no proper way of writing the prescription. The best way of doing it is writing the name of the active as well as the strength. But this is not good at all times. For example, prescribing drugs such as insulin, warfarin, theophylline and epilepsy drugs with narrow therapeutic index using different products from different manufacturers can pose serious health challenge for the patient. In these cases, pharmacist do not generally change a name of a drug brand or generic.
The reason is that there is always a batch by batch variations for each product from same company. The variation is known to always fall within a particular range. Switching to a different brand can be bad especially if that companies product batch variations is a little bit high or lower than the normal batch by batch variations from the other company. It can be generic or brand drug. In such cases, a medical doctor can  inscribe on a prescription  form 'do not substitute.' There is about 3-4% batch by batch variations within same company producing same products. But aside from these conditions, other drugs are suppose to be safe and efficient when use according to the prescription.
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When a medical doctor writes the name of the active ingredient and both brand or generic, it saves the patient the stress of buying an expensive product. The patient can then go for a lower substitute depending on the cost. But this will then leave power in the hands of pharmacist in stocking a product that pay them or from a friend's company not minding the economic implications of such acts. But when a particular brand is written, which in most cases is caused by big pharma reps paying money for them to write it, it push up the cost of medication especially if it is a brand drug. The money given to the prescriber must be recovered from the patient. Most health insurance company use generics.
The setting describe so far is a true representation of places like the united states of America. Thesame cannot be said of our own generics here in Nigeria. Many of them try to bypass standard operating procedures. They end up producing drugs not as effective as the brand. I remember an experiment back in school where same active from different companies produced different result while two fell below the standard out of about 10. This is the main reason many patients are specific as the name they trust. So, it may not be related to persuade patients on alternative because there are companies who have really mess up big time causing some unwanted effect.
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