OK, first time ever: branded vs. generic = explained

[Ted-T]

Visited, with my wife her Epileptolgist this morning for routine appointment.

My wife cannot use the generic for Lamictal.

As we shall soon be switching mail order pharmacies (USA based), I raised the need for an appeal to the new supplier to ensure that my wife’s need for branded Lamictal is met, without push-back or undo expense.

The doctor remarked that a generic can be OK, but the issue is that some generic manufacturers do not adhere to strict weights; meaning there can be a variance of ~20% greater or less than the specified dosage potency or more. Hence, the issue for those who ingest the generic is the total lack assurance of a constant dosage potency.

Separately, he remarked that if the patient can safely use a generic, without adverse effects, e.g.: seizure activity, there is no guaranty that the pharmacy will continue to use the same generic supplier long term. Why? The pharmacy dispensing firm, goes out to bid; meaning which generic manufacturer can supply the required medication in the dosage needed at the lowest cost. So a dispensing pharmacy switches suppliers (based on results of the bid process) at any time without any warning.

The dispensing pharmacy gains and the patient loses.

Further, the USA’s FDA will not mandate adherence to a narrower band of potency and thus the manufacturers are a bit freewheeling in their production.

= = = = =-

Alas, our government in action, or inaction, at its best.

[Porkette]

Hi Ted,
Just like your wife I can't use a lot of generic seizure meds because they are a lot weaker and don't work as well. Here the company making the drug increases the prices but people
are getting less. You and your wife may want to report this to the medical conduct board and they will take action on the matter.
I wish you and your family only the best and May God Bless You!

Sue

[Ted-T]

Thanks for your kind words.

Unfortunately, I do not have a specimen of the generic to provide “proof” as to its actual potency level.

Her Epileptologist was on a committee for “standards” and he is the one who commented to us about the US FDA’s lack of a firm stance on the issue: standardized potency for generics.

Regards to all.

Ted

[jingle]

Ted -- I must use Express Scripts/Tricare. My prescription for Trileptal is issued by the Adult Epilepsy Center of a huge hospital and they always put "brand name only" (or whatever the necessary words are) on each order. They have been doing that for about 3 years and there has never been a problem. Hurrah.

[Ted-T]

Our issue is not with the Epileptologist who recognizes the need for branded Lamictal and who writes the prescription for the branded Lamictal.

The issue is with my corporation’s pharmacy plan and dispensing company, which charges retail for branded Lamictal. It did charge retail, until my wife’s Epileptologist filed an “appeal” explaining the underlying rationale for the branded regimen. The dispensing firm then reduced the fee dramatically.

Soon we shall face the same issue as I am leaving my current firm and its pharmacy plan. However, as we met with the Epileptologist last week, he is prepared to submit another appeal on my wife’s behalf to the new dispensing firm.

I’ll post our experience in a about sixty days.