Multiple drug brands confusing

A PAMPHLET produced by a pharmaceutical company may perpetuate the misconception that generic drugs are not as effective as branded drugs, according to a leading pharmacologist.

The pamphlet, produced by Nycomed and distributed to general practices, listed various reasons why consumers should be cautious when choosing generic drugs.

“You could find yourself substituting the tried and trusted brand prescribed by your doctor with a generic copy at no cost saving at all”, the pamphlet said.

It stated that generics were not always cheaper than the original drug, that the variety of names and packages used by generics could cause confusion, and that the different inactive ingredients used in generics could cause allergic reactions.

Professor Ric Day, professor of clinical pharmacology at the University of NSW, said the pamphlet may lead consumers to believe that generics are not as good as the original drug.

“For generic medicines, their performance is the same — and that’s the one thing that’s being undermined to an extent … there’s clearly a self-interest at play here”, he said.

He said although allergic reactions to inactive ingredients were likely to be “vanishingly rare”, they were possible.

However, Professor Day said the pamphlet did highlight the important issue of potential patient confusion due to the multiple bioequivalent drugs available.

Professor Day coauthored a paper in the latest MJA which said that the proliferation of generics led to increasing brand substitution, which raised the potential for confusion and medication misadventure. (1)

For example, although only eight different ACE inhibitors were used in Australia, 81 different brands were available.

“Consumer confusion and adherence problems are related not only to names but also shape, colour, taste, packaging and excipients”, the authors wrote.

Despite this, Professor Day told MJA InSight that generic drugs did save the government money, and their responsible use should be encouraged.

The authors called for an urgent change to drug labelling to reduce the risk of confusion and duplicate prescriptions.

“We call on the responsible authorities, as a matter of urgency, to amend Australian and New Zealand labelling laws to ensure the active ingredient or generic name is displayed more prominently and in a larger font than the brand name on all pharmaceutical labels”, the authors wrote.

Dr Jenny Martin, an associate professor of clinical pharmacology at the University of Queensland and Princess Alexandra Hospital, said the labelling suggestion could contribute towards patient safety, although she expected there would be resistance from industry.

“Some negotiation with industry would need to occur to ensure this was successfully implemented”, she said.

Dr Martin said the price of generic drugs was often similar to the branded drug, as stated in the Nycomed pamphlet. She said Australian consumers paid substantially more for generics than consumers in the UK or New Zealand and only a minimal amount of the cost benefit seemed to be passed on to consumers or the government.

Both Dr Martin and Professor Day said they regularly saw patients who were unwittingly taking multiple brands of the same medication.

Professor Day recommended that health professionals regularly review their patients’ medication, particularly with older patients, or those taking multiple medications.

“Ask patients to bring all their medication in, or book a home medicine review”, Professor Day said.

He also suggested that doctors improve their communication with patients to ensure patients know more about their medicines.

“The more patients understand what their medicines are for, which ones they are taking, what the proper names for them are, the safer everyone will be”, he said.

Nycomed did not return MJA InSight’s request for comment.

- Sophie McNamara

1. MJA 2011; 195 (11/12): 650-651

Posted 12 December 2011

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