Thursday, December 4, 2008

Generic Cardiovascular Drugs Are Just As Good

A study published this week in the Journal of the American Medical Association reports on findings that brand name drugs are not more effective than generics for treating cardiovascular disease.

Because of financial concerns, many patients and doctors have been substituting brand name heart disease medications with their generic, and much cheaper, versions. A research group at Harvard Medical School in Boston compared studies that looked at the differences between generic and brand name meds between 1984 and August 2008.

Though the majority of expert editorials published during that time scoffed at the interchangeability of the drugs, research studies painted a different picture. For nine different classes of cardiovascular drugs, including beta-blockers, ACE inhibitors, and statins, there was 100% equivalence between generics and brand name drugs. Diuretics and calcium-channel blockers were an exception with 91 percent and 71 percent equivalence, respectively.

In 24 years, researchers have also not reported toxicity differences for generic and name brand warfarin.

Kesselheim et al note, “One explanation for this discordance between the data and editorial opinion is that commentaries may be more likely to highlight physicians' concerns based on anecdotal experience or other nonclinical trial settings. Another possible explanation is that the conclusions may be skewed by financial relationships of editorialists with brand-name pharmaceutical companies, which are not always disclosed. Approximately half of the trials in our sample (23/47, 49 percent), and nearly all of the editorials and commentaries, did not identify sources of funding.”

When seeking treatment for cardiovascular disease, including hypertension, expensive and well-advertised brand name medications do not offer a benefit over the less expensive generic formulations. In many cases, the generic is an identical chemical, though pharmaceutical companies attempt to patent everything from route of administration and pill coating to uses and dosage to prevent competitive generics from coming to market. This does not appear to have been successful for this particular type of drug, those for cardiovascular disease.

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