Whether we like it or not, we are made to pay a visit to the chemist every once in a while. And when we do so, the chemist often gives us a medicine that has a different ‘brand name’ than the one prescribed by the doctor. The ‘ignorant’ us, however, insist on the same name as written on our prescription while the chemist makes a futile attempt at making us understand that though the ‘brand’ name may vary, the ‘generic composition’ of the drugs is the same. For example Ibuprofen, the Non- Steroidal Anti-Inflammatory Drug (NSAID), is sold under more than a hundred brand names such as Brufen in India, South Africa, Egypt and United Kingdom, Advil in the United States of America and Turkey and Hedex in Kenya and Uganda. However, we pay no heed to the chemist’s rant and move to another retail pharmacy. Because when it comes to health, there is no room for a compromise.
Choosing generic drugs – a compromise?
But are we really compromising with our health while opting for generic drugs? To answer this question, one needs to understand what generic medicines are.
A sizable part of the population is still unable to wrap their heads around the concept of ‘generic drugs’. The theory, however, is not rocket science. Consider this – You go to a shop to purchase a pack of plain salted potato chips. Now, at the retail store, there are different brands say Jumble Chips, Kays and so on. Their trade name is different, their packaging is different, and their mode of advertisements are different. But the core component i.e. the ‘plain salted potato chips’ is the same.
It’s like you pay $3 for a coffee at a ‘renowned café’ and pay half of that amount for the same coffee from a local coffee vendor. As simple as that! Generic drugs are equivalent to branded drugs in their dosage, strength, route of administration, quality, performance and intended use. The drugs are sold under the name of their chemical composition and not under the brand name because brand carries the baggage of costs and thus, holds the reputation of being expensive.
However, the most important question that comes to everyone’s mind is if the generic drugs are similar in every aspect to their branded counterparts, then why are these drugs light on our pockets?
Generic Drugs v/s Branded Drugs
Whenever a drug is manufactured, a pharmaceutical company that develops the drug has to bear the initial costs of research and development, patent, marketing and selling a brand new drug in the market. The process begins with 5,000 to 10,000 drug candidates going through clinical trials. The drug that steers clear of all the tests is selected. Then, the patents are issued which includes licenses for patent protection and drug development. After that, the medicine is sent for approval by a regulatory authority and then the drugs reach the market to the consumer.
This process can take as long as twelve years. This time and resourceconsuming process and the cost it incurs is absent during the manufacturing of generic drugs. Generic drugs are not associated with a particular company and come under the umbrella of government regulations in the country where they are dispensed. Hence, no marketing costs are involved. This reduces their cost by about 80% to 85%. Generic drugs, thus, save an estimated $8 to $10 billion a year.
If you are the original developer of a drug and the patent protections i.e. the exclusive rights to the product afforded to you have now expired, then other players in the market can manufacture that drug at a cheaper rate without worrying about patent costs. Thus, competitors enter the market and the price comes down. For example in the early 1980s, Captopril, a ground-breaking heart failure medication, was introduced by Bristol Myers Squibb under the trade name Capoten, and the company made a fortune from the sale of that drug. However, when the patent ended and the drug went generic in 2013, the drug could be purchased at just 1.4 cents.
Both generic and branded drugs have the same strength, use, mode of intake (for example orally as a pill, syrup or inhaler) and they both get a thumbs up in efficacy. They both may be different in terms of colour and flavouring but have the same active ingredient in the same proportion. The composition of inactive ingredients may differ, however, that does not affect the performance of the drug, its safety or effectiveness because the active ingredient is the same. In short, the process of manufacturing the drugs may vary, their appearance and packaging may differ, but the end result is the same.
Generic drugs are the ‘plain Jane’ version of their branded equals and are sold with simple packaging without much fanfare. They have the same bioavailability (fraction of a dose of drug that gets absorbed in the body) and bioequivalence (i.e. no significant difference between generic and branded drugs) and have the same manufacturing standards. The only criteria that differs is “cost”.
The Placebo Effect
Whenever an attempt is made to bring about a change in the status quo, it faces some kind of opposition or a certain reluctance from the society. And people may take months, years or even decades to get used to the new development. The same case happened with the concept of ‘Generic Drugs’ when the concept was introduced for the first time. However, the only psychological barrier that inhibits the consumers from availing the generic drugs is their perception and their expectations from the brand name.
In an experiment conducted to study the behaviour of consumers, 20 subjects who reportedly had headache were divided into groups of two – 10 subjects each. The first group was asked to just sit and do nothing whereas the second group was told that they were the lucky recipients of a powerful painkilling ‘branded’ drug. In truth, the second group was merely given a ‘sugar pill.’ After half-an-hour, when subjects of both the groups were asked for their responses, the ‘do nothing’ group reported that they were still suffering from a headache, while 9 of the 10 people of the second group reported the complete disappearance of pain. This shows that there response was based on their perception and not on the quality. This is known as the Placebo Effect.
Access to medicines for Africa and the world
Though the adage ‘Health is wealth’ may sound like a cliché, it stands true in every sense of the word. We live for health. All the material luxuries have no value if one does not have sound health. Imagine, you have all the delicacies of the world spread on the dining table but you have Herpetic gingivostomatitis (infection of the mouth and gums) and, therefore, you cannot relish those savouries. Africa and people all over the world have the right to access to medicines, especially the medicines that cure chronic diseases such as cancer, diabetes and respiratory diseases and this is possible with generic drugs. Because a healthy life is everyone’s right.
