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Myths about generic drugs – getting beyond the anecdotes

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Glad to see Naomi Freundlich on Maggie Mahar’s Health Beat Blog address a column that the New York Times published last month, “Not All Drugs Are The Same.

Freundlich points out, appropriately, that:

“The “controversy” over generic drugs is really less than meets the eye. There have been scattered concerns–some based on patient or doctor reports, others from proprietary drug makers–about generics not being biologically close enough (bioequivalent) to name brand meds. But the issue is mired in complexity and misinformation. For example, many doctors accept significant payment from drug companies to promote their name brand drugs–especially cardiologists and psychiatrists. It can be hard to remain unbiased when a pharmaceutical company is paying the tab on research.”

She quotes Aaron Kesselheim, an instructor in medicine at Harvard Medical School who has authored studies comparing generic and name-brand drugs saying the NYT column was “pretty irresponsible” because it doesn’t reflect the body of evidence supporting the use of generics. “For the vast, vast, majority of pills and the vast, vast majority of patients there is no evidence of problems substituting generics for brand name drugs,” he said.

I heard similar complaints about the column from Larry Sasich, consultant to the Public Citizen Health Research Group and co-author of “Worst Pills, Best Pills” — and from Dr. Stephen Schondelmeyer of the University of Minnesota College of Pharmacy. Sasich wrote me: “The journalist covered the science but then used the experience of a patient and a physician as rebuttal to the evidence that there has been no credible evidence that generic drugs harm patients. This seems counter to good scientific journalism as uncontrolled observations were evidence that generics can cause harm.” Schondelmeyer has told me for years that he continues to be perplexed by people who continue to breathe life into the “generics aren’t safe or aren’t equal” arguments.

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