Eli5: what is the difference between a generic drug to the original drug, and why do some doctors will swear by the original drug?
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Hi, I work in European intellectual property. There’s some great points being discussed but also there’s a key IP point no one seems to have mentioned yet – patent thickets.
Basically, when a drug company finds a new drug, they patent it – gaining the rights to stop others from using that drug for a fixed period of time. When that runs out, other companies can sell generics with the “same” active ingredient.
HOWEVER, the drug company didn’t sit on their pile of money, forming wads of notes into a comfy sofa, they found other little inventions around the drug:
– the best way to put the pill together for the best release profile,
– the best way to crystallise the drug to have the best response profile,
– the best dosage regimen to treat the disease,
– the best way to make the drug itself
All of these inventions can be patented, forming a thicket of rights around the drug. And because these are discovered later than the drug itself, the monopoly from those patents runs out later (this is called “evergreening”).
So, the generic companies may be able to sell pills with the “same” active ingredient, but they may not (yet) be able to sell pills with the optimum results, so they may have to tweak other things to provide the same dose-response to be allowed to sell them, which can cause toxicity issues etc.
related but i just started ssris and my doc said theyre all chemically identical or whatever but people still react to them slightly differently and theyre unsure why
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Doctors have an endless line of drug company representatives who are usually very cute, buy them lunch, offer them “expert paid speaking roles”, and encourage them to proscribe the name brand drugs and the latest drug that is 1% different than the previous drug which is now generic. Doctors like to have cute people buy them lunch and pay them money, so they often do it and prescribe the name brand drug.
My mom is a doctor and she told me that sometimes she prescribes brands over generic (or more expensive brands over other brands) because of the ways she has seen the patients react to them. This is specially true for medicines that affect your stomach, so she would tell people that the brand was more expensive, but the stomach side effects would be milder, so it was up to them to choose.
Sometimes, not always, it comes down to the type of donuts, quality of coffee and popularity of the free pens that the drug companies bring to the doctor’s office. Perks per se.
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Generic is basically the same product without the name or branding. Doctors swear by the original because they get paid to do so.
another interesting difference between brand name and generics that i haven’t seen mentioned is that generics are allowed to differ in chemical matter if they show a certain (high) degree of efficacy equivalence. that means that for some (small number of) people the generic may be less effective than the original brand name. i speak from personal experience with a medication i take being expensive and insurance wanted me on the generic. problems arose quickly and it took nearly a year to figure out that my body was absorbing only ~50% of the active ingredient due to the generic being slightly different. I eventually got permission to switch back to brand name & problems went away immediately
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