Generic medicines have thrived in the last few years, and I have misgivings. For all the many failings of the big established drug companies (and there are many) at least they have researched and developed many of today’s drugs – which can be viewed with dismay anyway, as I have outlined.
Generics don’t change this – they simply offer the same dubious benefits as the original drugs, but cheaper. The generic companies don’t do any research or development – they wait until patents expire and then produce and market a copy.
There are some pitfalls here: often the generic is not bio-equivalent to the original; they may have different fillers, preservatives etc., and could be quite different in their bio-availability, absorption rates, elimination rates and side-effects. They also come under a bewildering array of names, which gives rise to errors and confusion and there are many cases of doctors not realising that a patient is taking the same drug under two different names.
There is a psychological effect with many people relying on established brand names. The most notable one here is “Ventolin” with asthmatics depending on it heavily. If you are struggling for breath, Ventolin is rightly viewed as a life-saver, and the dependence is so strong that many will refuse cheaper generic versions.
In Australia, generics have been encouraged and promoted by Governments in an attempt to lower the overall health bills. This is done via the Pharmaceutical Benefits Scheme (PBS) where drugs are listed and subsidised. Listing on the PBS is supposed to be on purely medical grounds, but as in every Government/ Private partnership, there are many ways to pervert the system.
Drug company lobbyists exert influence on doctors and pharmacists with gifts, and sway politicians with electoral and financial help. The PBS pays pharmacists each month for the drugs dispensed and subsidised and the payment is based on wholesale drug prices paid by the pharmacy. This is where the generic companies (and pharmacists) have been ripping off the system for years.
To encourage pharmacists to use their particular brands, the companies offer huge discounts or bonus stock (or both), reducing the listed wholesale price to half or even less. This is not passed on to the PBS or to patients using generic drugs. It always amused me when I heard some pharmacists say to patients– “Would you like the cheaper generic Aussie brand”, knowing that the pharmacist was reaping a financial benefit and that the “Aussie brand” was usually made in Mexico, South Africa or the Philippines.
In Part Two of this article, I will examine how the PBS scheme is wide open to fraud and rorting.