Original or generic: pros and cons
Which medicine should I choose – generic or original drug?
Nika Batchen, KM.ruIn the media and the Internet, the notorious decree of the Ministry of Health is being discussed with might and main.
According to it, from July 1, 2013, doctors will be required to prescribe cheaper medicines to patients, so-called generics, if the drug contains the same active substance.
Conversations and disputes do not stop, oncologists and specialists in rare diseases are horrified, claiming that a generic drug is able to kill a weakened patient and nullify long-term treatment. District therapists and pharmacists just shrug their shoulders – they often recommend generics to patients if they do not have money for expensive drugs. Which of the experts is right in this case?
Elizabeth, Betsy, Bessie or Bess?To understand the problem of generics and original drugs, you need to start with their composition.
What is a medicine? The main active ingredient, for example, drotaverine in no-spe or acetylsalicylic acid in aspirin, less often – a combination of two or more active substances (bromisovaleric acid and phenobarbital, as in valocordin), additional therapeutic components (vitamin C in cough drops), if necessary, dyes, sweeteners, etc. and the basis is starch, cellulose, alcohol, oil, saline solution or other neutral substance. The percentage of the active substance in a tablet or injection solution is called the dosage. The more active substance, the stronger the medicine turns out to be, the more expensive it – theoretically – should cost. But in practice, everything turns out to be not so simple.
The price of the medicine often includes the cost of the brand – 9 out of 10 buyers, having a choice, will prefer a well-known brand to an unknown drotaverine. Often manufacturers are deceiving, displaying an impressive composition on the package in large letters, and in small numbers – a meager dosage of active substances. The opposite situation is also possible – a little-known Russian, Belarusian or Indian company produces a drug with a good dosage of the drug, but is forced to put a lower price because the brand is not known to anyone, and it remains to attract buyers with cheapness.
Just as the widespread English name Elizabeth has many abbreviated variants that are not very similar to it – Betsy, Bessie or Bess, so many completely different drugs can contain the same active substance. For example, "Azitral", "Azitrox", "Azitrocin", "AzitRus", "Azicide", "Zetamax", "Sumamed" are essentially the same antibiotic azithromycin. Conversely, the similarity of the names does not mean the identity of the composition – for example, "TeraFlu" includes paracetamol and phenylephrine, and "TeraFlu BRO" – only essential oils. Therefore, before buying any medicine without a prescription, you should carefully study the instructions to make sure that you are being sold exactly what you need. One question remains – why not really buy cheap drugs, leaving pharmaceutical concerns "with a nose"? Alas, a high dosage is not enough for the quality of the drug.
From the drug to the pillSeveral hundred years ago there was no order in the pharmaceutical field.
Any charlatan could regale his patients with any rubbish – from bat droppings and the blood of executed criminals to arsenic, mercury and crushed emeralds. Just a hundred years ago, children's syrup could be freely purchased at any pharmacy in the USA... with heroin, seventy years ago – amphetamine pills and barbiturates. At the same time, pharmaceutical production was distinguished by an interesting feature – there were quite a few mass-produced drugs with a completely identical composition. Much more often, the doctor wrote out a prescription, the pharmacist mixed the necessary components into pills, syrup or powder and sold them to the patient. The risk of error existed constantly, the toxicity of drugs was studied almost exclusively in practice, that is, on the patients themselves, and the side effects of treatment were not particularly thought about.
The pioneer in the production of mass medicines was the company "Bayer". Felix Hoffman synthesized acetylsalicylic acid, the patent office in Berlin issued a certificate, and since 1899 the famous aspirin has been sold in incredible quantities. It replaced salicylic acid, harmful to the stomach, and became an alternative to narcotic painkillers. The phenomenal success of aspirin stirred up the market, new mass-produced drugs began to appear. But now, not dozens of customers of one pharmacy could suffer from an unsuccessful drug, but tens of thousands of patients.
After several high-profile scandals related to the toxic and teratogenic effect of new drugs (thalidomide, etc.), control over drugs, their production and composition has tightened. Today, in order to release a medicine, laboratory tests must first be carried out, then its effectiveness will be tested on animals, a clinical study will be conducted on volunteers and only after all the checks will be released for wide sale. The exact name, exact composition and exact dosage will be patented. The entire duration of the patent (10-15 years) only the company that developed it will be able to produce the drug. At the end of the patent period, the recipe is "opened" and everyone can get a certificate of identity (compliance with the formulation, exposure, form of release) and start the production of generics.
Generic is a drug (from the English generic – tracing paper), the active substance of which coincides with the original, and the dosage, full composition and name differ slightly. Some generics practically coincide with the originals and undergo their own (although not such large-scale) clinical trials, additional components are introduced into the composition of others, the basis for the drug is changed, etc. Unfortunately for patients, the quality of purification of the active substance from impurities can also be different. According to statistics, up to 80% of medicines in Russian pharmacies are generics produced at Russian, Indian, Chinese factories under license or, alas, even without a license and verification. However, in the markets of the Netherlands, Germany and the UK, the share of generics is even higher, reaching 50%.
Making a smart choiceHow to navigate the pharmaceutical market – after all, our health and our loved ones depend on the right decision.
Consider the advantages and disadvantages of a generic drug.
+ Generic is more accessible than the original – it is not easy to find a patented drug, it can take precious time.
+ Generic is cheaper, and the difference can be hundreds or thousands of rubles per package.
+ The generic is just as effective – if the dosage is synchronized correctly, there will be no significant difference in the effects of the drugs.
+ Generic allows you to decide on your own, and not choose what advertising imposes.
– The quality of purification of the active substance in the generic may be insufficient.
– Additional components may be toxic or cause side effects.
– There may be an allergy to the drug, complications with the administration of the drug.
– The effect on the body may be excessively strong or insufficient – due to changes in the formulation.
By standards, the rate of absorption, distribution in blood and tissues and other indicators of the effects of the generic and the original may differ by 15-20%, the amount of impurities is sometimes up to 32%. But this does not mean that generics are ineffective or harmful. Pharmaceutical companies absolutely do not need lawsuits from patients and their inconsolably grieving relatives, they most often care about the safety of their customers and the quality of products. At least, large firms, well-known concerns and manufacturers. Therefore, when choosing a generic, it is necessary to choose it not only by price, but also by the manufacturer. Keep in mind that Chinese and sometimes Indian manufacturers do not always follow the recipe exactly. In addition, counterfeit counterfeit medicine, as a rule, can be distinguished by the packaging and instructions – bad paper, blurry printing, unusual color of tablets, as if they say: "don't buy me!"
When purchasing a remedy for headaches, mild colds, coughs, corns or sciatica, you will most likely simply not notice the difference between a generic and an original medicine. But when it comes to the treatment of stroke, multiple sclerosis, oncology and other serious diseases, when any complication can become fatal for the patient, it is better not to take risks with generics. Remember that not only the doctor is responsible for the outcome of the disease – discuss with your doctor all prescriptions and a number of medications, including generics. Make the right choice!
Portal "Eternal youth" http://vechnayamolodost.ru16.05.2013