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Generic Prescribing

  • 14-11-2019 11:33pm
    #1
    Gael23
    Registered Users Posts: 12,086 ✭✭✭✭


    I take a biologic drug which has recently come off patent. Now of course the hospital are trying to switch me cheaper generic version. I don’t want this because I have a collection of medical issues and these are “similar”, not the exact same. I’m worried about the one thing that is different casing a problem.

    My question is can I resist this and stay on the brand leader that works and gives me a quality of life or is it up to the hospital? I’m prepared to go to someone privately if needs be.


Comments

  • #2
    duffman13
    Registered Users Posts: 8,945 ✭✭✭duffman13


    Gael23 wrote: »
    I take a biologic drug which has recently come off patent. Now of course the hospital are trying to switch me cheaper generic version. I don’t want this because I have a collection of medical issues and these are “similar”, not the exact same. I’m worried about the one thing that is different casing a problem.

    My question is can I resist this and stay on the brand leader that works and gives me a quality of life or is it up to the hospital? I’m prepared to go to someone privately if needs be.

    If they are generic they are the same thing as what you've been on, just a different brand. If your paying for your medication you can choose to pay for the branded version. If you are public, unless a doctor states otherwise, you take the generic or pay the differential in price yourself


  • #3
    Session2019!
    Registered Users Posts: 26 ✭Session2019!


    Generics although have the same active ingredient they often have different inactive ingredients such as additives, preservatives and dyes so they are slight differences but not enough to change how the active ingredient works.

    Really up to you if you want to pay for the branded version of the drug or cheaper generic. Numerous studies available online if you want to read the fors and againsts for both.


  • #4
    Wesser
    Registered Users Posts: 1,813 ✭✭✭Wesser


    Do you have a medical card?


  • #5
    Gael23
    Registered Users Posts: 12,086 ✭✭✭✭Gael23


    Wesser wrote: »
    Do you have a medical card?

    Yes I do and I also have private medical insurance so can get seen in the private system if that’s what’s needed


  • #6
    Wesser
    Registered Users Posts: 1,813 ✭✭✭Wesser


    If you are obtaining your medication through your medical card you should be on the cheaper medication as that frees up money to be used in other areas of the health system. You should at least try the generic medication and give it a fair chance as if it is available cheaper that saving can be used elsewhere in the system .


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  • #7
    locum-motion
    Registered Users Posts: 5,143 ✭✭✭locum-motion


    With respect to the 3 previous responders, you missed the point when the OP said s/he’s on a ‘biologic’ drug.

    This means that the OP is on what’s called a High Tech drug. And because it’s manufactured through biochemical rather than chemical processes, it’s not quite as simple as generic substitution is with ordinary medications.

    With, say, a blood pressure medication, the original and the generic equivalents are exactly that; equivalent.

    With the more complex structures of a biologic drug, getting it absolutely identical is difficult, hence they are described as ‘biosimilar’ drugs.

    That being said, the OP should not be nervous about switching to the biosimilar. It will work in the same way.

    Also (and of course this will depend on which biologic you’re on), going to see a doctor privately is all very well, but if you step outside the publicly funded system for procuring the drug, you will get a nasty surprise when you find out now much they cost. Unless you have thousands of euro in disposable income each month, you won’t be able to afford to pay for the drug privately.


  • #8
    echo beach
    Registered Users Posts: 1,252 ✭✭✭echo beach


    Gael23 wrote: »
    My question is can I resist this and stay on the brand leader that works and gives me a quality of life or is it up to the hospital? I’m prepared to go to someone privately if needs be.

    Are you prepared to pay privately for the brand which will be several thousand euro a month for a biologic drug?

    These are marvellous drugs that do give many people a quality of life they could only dream of a decade ago. It is the drug that is doing you good not the brand and patients in Ireland are fortunate to be able to access it for free or at modest cost.


  • #9
    Gael23
    Registered Users Posts: 12,086 ✭✭✭✭Gael23


    Were talking 20k a year for the medication which more than half my income so I can’t possibly do that. What I can do is see a consultant in a private hospital who might look at the medical justification more than the cost.Locum motion is correct abd addresses my concern. I know the biosimilar will work for what I want it for. But what I don’t know is what impact the different ingredients will have on my other medical issues


  • #10
    locum-motion
    Registered Users Posts: 5,143 ✭✭✭locum-motion


    Gael23 wrote: »
    .... But what I don’t know is what impact the different ingredients will have on my other medical issues

    Do you mean that you’re worried about the rest of the ingredients rather than the actual biologic itself?
    If so, you need not worry on that front either. Basically, the other ingredients are chosen because they do their job (ie helping the ingredients slide smoothly through a tableting machine or regulating the acidity of the final product or whatever) without having any actual effect in the body. That’s why they’re called inactive ingredients.


  • #11
    Gael23
    Registered Users Posts: 12,086 ✭✭✭✭Gael23


    locum-motion wrote: »
    Do you mean that you’re worried about the rest of the ingredients rather than the actual biologic itself?
    If so, you need not worry on that front either. Basically, the other ingredients are chosen because they do their job (ie helping the ingredients slide smoothly through a tableting machine or regulating the acidity of the final product or whatever) without having any actual effect in the body. That’s why they’re called inactive ingredients.

    Yes that’s my issue. I know the drug adalimumab will still be the same but other bits will be different. Also Humira is citrate free so doesn't sting


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  • #12
    locum-motion
    Registered Users Posts: 5,143 ✭✭✭locum-motion


    Have a look at this page, and expand the section entitled “Why has Amgevita been authorised?” It should allay your fears. (Amgevita is just one example of a biosimilar to Humira)

    https://www.ema.europa.eu/en/medicines/human/EPAR/amgevita


  • #13
    0lddog
    Registered Users Posts: 3,292 ✭✭✭0lddog


    Gael23 wrote: »
    ........ I know the drug adalimumab will still be the same but other bits will be different.......

    I have a recollection ( maybe someone could confirm ? ) that one of the equivalents is made by ......

    Samsung :D

    Its probably fine but it might help if The Koreans renamed the pharma company so that it did not carry the associations of the electronics company ( Whats the pharma version of the S7 spontaneous combustion debacle :eek: )


  • #14
    Grab All Association
    Registered Users Posts: 3,917 ✭✭✭Grab All Association


    I know someone who was given a generic version of Efexor XL and they ended up trying to take their life. The generic version of this drug is 3 x tablets in a capsule vs beads in Efexor.

    There’s some things you shouldn’t change. If you start on branded medicine, stay on it. Vice versa.


  • #15
    Gael23
    Registered Users Posts: 12,086 ✭✭✭✭Gael23


    Going to see a Gastroenterologist privately in December and take it from there. I’m in Humira for 2 different but related conditions, hence the complexity of my history. I have a prescription for Humira until April anyway so have plenty of time. Ordinarily I have no issue with generics but just with this one I feel the stakes are too high


  • #16
    [Deleted User]
    Posts: 8,647 ✭[Deleted User]


    Grab All Association wrote: »
    I know someone who was given a generic version of Efexor XL and they ended up trying to take their life. The generic version of this drug is 3 x tablets in a capsule vs beads in Efexor.

    There’s some things you shouldn’t change. If you start on branded medicine, stay on it. Vice versa.

    I would disagree with this. There wouldn't be any change in effect of the active ingredient. Sadly, people who are on venlafaxine have been diagnosed with "major depressive disorder". So as a subset of patients, are more likely to attempt suicide.


  • #17
    Graces7
    Registered Users Posts: 32,634 ✭✭✭✭Graces7


    When I was new here, the prescription said my usual Tylex but the pharmacy sent Kapake.

    Almost identical but without the caffeine

    I thought they had to give what was on the prescription? Was this a cheaper option?

    The real problem was the Kapake tablet size as I have swallowing issues so I got the pharmacy to change to Tylex in capsule form for that reason.


  • #18
    The Hound Gone Wild
    Registered Users Posts: 255 ✭✭The Hound Gone Wild


    Graces7 wrote: »
    When I was new here, the prescription said my usual Tylex but the pharmacy sent Kapake.

    Almost identical but without the caffeine

    I thought they had to give what was on the prescription? Was this a cheaper option?

    The real problem was the Kapake tablet size as I have swallowing issues so I got the pharmacy to change to Tylex in capsule form for that reason.

    There is no caffeine in Tylex.

    If you have issues swallowing request Solpadol caplets. They're the same again but they're quite small.


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