The way my family's health insurance works most of the time, we pay $45 per month for brand name pharmaceuticals that are on patent and $10 per month for drugs where the patents have expired and they've gone generic. So, the difference for maintenance drugs is $420 per year, which is not insubstantial.
Therefore, I look forward to the day when an old brand name drug goes generic. If I knew that a brand name drug would be patented for the next 10 years, which would cost me an incremental $4,200, I might have a serious discussion with my doctor about how much better the brand name drug sold by that moonlighting NFL cheerleader he likes is compared to the generic.
But, finding out when a drug will go generic is a hit or miss proposition, even with Google. The best site I found for one drug is a discussion forum for pharmaceutical sales reps where they bitch about when the company is going to lay them off when the drug goes generic. But even these guys (and gals) couldn't agree over whether the day of doom (for them, not me) was Christmas 2013 or Memorial Day 2014. Other evidence comes from firms' press releases for SEC purposes. But it's all very scattershot. And I'm a much better Google searcher than most pill consumers.
Shouldn't there be an official list somewhere of when each brand name drug will go generic and the contingencies that might delay it?
Typically the owner of the patent will pay off generic companies to not sell generics after the patent expires.
ReplyDeleteThis is illegal, but easy to hide. Eventually more generic drug companies will prepare to make it, and paying them all off becomes to expensive. THAT, is when the generic comes out. So maybe a year on average, but often longer.
Uh oh, is Steve in a manic phase again?
ReplyDelete4 posts for March 7 and it isn't even dawn yet on the east coast.
"Typically the owner of the patent will pay off generic companies to not sell generics after the patent expires."
ReplyDeleteThat seemed to be what was going on with Lipitor, the Big Kahuna of drugs that was supposed to go generic years ago, but then Pfizer and the Indian company that had the right to manufacture generic Lipitor announced an agreement that it wouldn't go generic for a couple of years extra.
That probably added $10 billion or so to American medical spending. How is that legal?
Buy Canadian. The drug industry is a racket anyways. But check out these links in the meantime. First and last link are most useful. The first link also links to the middle links.
ReplyDeletehttp://answers.google.com/answers/threadview/id/72072.html
http://www.fda.gov/drugs/informationondrugs/ucm129689.htm
http://www.fda.gov/Drugs/InformationOnDrugs/ucm129662.htm
https://securews.bcbswny.com/wps/wcm/connect/046e920045c9862899c5fb36fd53ce07/Drug%2BPatent%2BExpiration%2BTable.pdf?MOD=AJPERES
http://www.drugpatentwatch.com/ultimate/preview/#.UThw5lEy70c
UpToDate tells if a particular drug is currently available as a generic, and it gives a link for patients to look up drugs, called "Orange Book." You might try that.
ReplyDeleteI might have put in the wrong link.
ReplyDeleteThe Pfizer 10K lists the expiration date (or the year, and year and date for nearer maturities) of its portfolio.
ReplyDeleteYou could always go to the PTO website and look up the actual patent -- it will expire 20 years after the filing date plus whatever extensions for government delay (generally FDA approval related) -- all the relevant information is on the front page.
ReplyDeleteBut from the comments above, it sounds like the actual expiration date isn't necessarily the date when generics will show up on the shelves, so it may not be that helpful.
I think Steve must be all manic all the time, or this is just his default state. Even when you think he's having a slump, up comes a new takimag or vdare article he's been working on. I don't know how he does it.
ReplyDeleteI've had that same discussion with my doctor, Steve. Oftentimes I will take their free samples and see for myself that there is no real tangible difference between the new drug and a generic version of an old drug.
ReplyDeleteEr, some of those 'Canadian' sites aren't really Canadian-e.g. a mail drop in Winnipeg-and some of them are.
ReplyDeleteSteve,
ReplyDeleteYou probably want the Orange Book. It's on the FDA website, and it lists, for each branded drug, the patents which the manufacturer registered with the FDA and when they expire.
But, these patents often become subject to litigation. Also, the Orange Book has omissions. So, the real answer is that nobody really knows exactly when a drug is coming off patent.
I don't use any prescription drugs myself, but I've heard that they are a fraction of the cost across the border in Canada or Mexico.
ReplyDeleteLike your point about the moonlighting NFL cheerleaders. When I was a young internal medicine doc in private practice all the detail men were, well, men. Some were just out of college but others were middle-aged and older. Some of them had called on my dad for years. Some of the actually knew a lot about the medications they were shilling. Then the change began.
ReplyDeleteA few years ago I agreed to give a seminar to a group of residents only to find out it was a "drug dinner." Couldn't back out. The detail woman was the prototype college cheerleader. I decided to have some fun with her. Began to ask about half-life, cytochrome P450, volume of distribution in the elderly and so on. It was priceless like the American Express commercial. She promised she would send me some literature. She didn't.
I'd also be interested in knowing what the difference in effectiveness between even non-generics and their nearest generic equivalent.
ReplyDeleteIf an expensive drug has only a very marginal benefit over a generic alternative but is 1/10th the cost, I'd like to at least start with the generic first to see if it effective enough.
try wikipedia
ReplyDeleteChristmas vs Memorial Day: drugs go generic in two steps. For the first 6 months, only one generic version is available and the price doesn't change much. Then any generic is allowed in.
ReplyDeleteCall the drug information specialist of the pharmacy department of your local academic medical center. Pretend to be on staff as a physician. They will get you that info lickety split.
ReplyDelete"But pharmaceutical companies deny that sex appeal has any bearing on hiring." from the NYT story
ReplyDeleteThat one doesn't pass the laugh test. I've noticed they do hire hunks too though.
Your insurance company maintains a prescription drug list, showing approved drugs, their generic equivalents and your copay for each. Here is my insurance company's. If you open it in Adobe Reader, it's easy to search:
ReplyDeletehttps://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Pharmacy%20Resources/PDL_Phys_Bk.pdf
Steve,
ReplyDeleteCheck the FDA "Orange Book," which lists all patented pharmaceuticals.
If you look up the drug (by drug name or by trade name), you will be able to see if it is prescription or OTC.
http://www.accessdata.fda.gov/scripts/cder/ob/default.cfm
In a pinch you can ask the pharmacist to substitute a generic drug for the brand (which is allowed unless the physician specified no substitution on the original prescription).
ReplyDeleteMaybe you should reconsider taking Lipitor altogether. Personally I had some bad side effects from it. The statins in general are fraught with side effects. But the thing that has always bothered me is that their mode of action is not well understood. They are beneficial in lowering cardiac deaths but almost certainly not for any effect they have on colesterol.
ReplyDeleteThey work by interfering early on in the biosynthetic pathway of their target. They therefore alter many others processes not intended.
These are very profitable drugs. Billion dollar companies want them to work. I expect some discoveries about their long term effects in the next few years that will point us toward drugs that are simpler in their actions.
Albertosaurus
$8 to $3...see what I mean? Shrinkage in the frontal lobes.
ReplyDeleteI've recently resorted to ordering a brand name medicine on-line from a Canadian website. The price is reduced from $25 per pill $2. I was a bit leary at first, but got reliable referrals from trusted sources, and the med seems to work as designed w/o any side effects. It is, however, mailed from India.
ReplyDeleteSteve, by and large the cheerleaders aren't trying to convince doctors that the brand name drug is superior to the generic version. By definition they're supposed to be equivalent. The cheerleaders and commercials want to convince you that the brand name is better than other cheap drugs that have already gone generic.
ReplyDeleteThis is how we got the "death panels" phrase. The GOP doesn't want any government funded cost-benefit research on drugs and devices that would cut into PhRMA profits, since many new drugs aren't actually much better than existing generics. (For trolls, there's no issue of rationing when the research would be for government funded or subsidized insurance like Medicare, so don't embarrass yourself by commenting; if the taxpayers aren't willing to help you pay for the crappy but expensive drug you want then you have the right to pay out of pocket or buy your own insurance policy.)