I am one of those drug reps that you hate see walking through the door but
I have to ask a serious question. Do you think that generic Coreg is
equivalent in efficacy/tolerability to the branded Coreg? Also, since there
will be 14 potential manufacturers of generic Coreg, will they all have the
same effect? Hasn’t there been alot of difference with the generics for
metformin? Maybe not? I would like serious responses because if generic
Coreg is as good as the branded then that will be great for your customers.
They will be getting the best beta blocker at an affordable price. How
about the patients that switch from branded Coreg or Coreg CR to the
generic? Do you see any problems in regard to potential decompensation of
their CHF? I know post MI and HTN patients will be different but the CHF
patient is a little more vulnerable. Also, how about the patient who has
the same co-pay or a little higher for branded or generic- would you
recommend that they switch to generic? This personally happened to me when
I got a script filled. I have the same co-pay and I was given a generic
without being asked. Wasn’t happy about it so asked for the branded that
the doctor wrote on the script.
Thanks for your serious reply.
I love it when drug reps use big words! Its so cute! But seriously, I dont understand how you can believe the stuff that GSK pounds into your brain and you extrude out of your mouth.
Tablet making isn’t rocket science. For the “variability” that you talk about, how do you know that the same “variability” isn’t present in the trade name? There isn’t some magical formula that the trade name company in making the tablets, and there isn’t some special machine that GSK has that proves equivalency between invidiual tablets that huge generic manufacturers (Mylan, QT, Watson, Dr Reddy) doesn’t already own. Their ass and reputation rides on their product much like GSK does. So yes, the tolerability and safety will be equivalent. Yes, generic Coreg is great for our patients HOWEVER your employer wants you to switch everyone over to their product so they continue to make a 5.8 zillion dollar profit and screw everyone over. Its business, plain and simple. If Coreg-CR was a superior product from the get-go, then they would of came out with Coreg-CR initally and not the IR. Amazing how GSK did the exact same route that Ambien and Paxil did; release an CR product when (gasp) their product just happened to go off of patent. I bet any money that Avandia-CR is in the works right now. You should of went the Clarinex/Lexapro route and purified an isomer to make doctors cream their panties when they hear about this ‘new discovery’.
You know what I’ve found with generic metformin? The patient eating birthday cake the night before he switched. Taking the new brand on an empty stomach vs always taking the old brand on a full stomach. I “don’t like the color” or “This one has the bad smell”. Yeah, totally irrelevant psychosomatic or outside variables that no drug company can compensate for.
With decompensation with CHF patient, if they are being treated correctly (meaning a Beta-Blocker, an ACE-I cranked up until cough then reduce by ~10%, Aldactone, lasix/K+) then they shouldn’t have any decompensation problems one bit. Of course Doctors dont want to put their patients on the “proper” CHF regime because its a lot of pills, so they just give them Coreg and some lasix and send them on their way (then wonder why they end up in the hospital).
If patients have the same copay between trade and generic (which they don’t), i’ll still fill the generic. Why? Because I dont want a $200 bottle sitting on my shelf when a $5 will do when there is no significant difference between the two. I’m on medication, my boss is on medication, and some of our staff are on medication. They are all generic (and we stock the trade name). Why? Because its cost-effective for the store, for us, and for our insurance companies. We do “the right thing(tm)” of our own free choice. I hate people who are so brainwashed that their doctors are some sort of deities and demand they get trade name Amoxicillin because their doctor wrote it on the prescription.
So, its time to ask you a few questions:
Take like Toprol-XL, Lotrel (Sandoz Brand), Zocor (when it /first/ came out), etc. Know what all of these have in common? Their generics are made by the trade name company. Do you still whine and push your “not equivalent” propaganda when the Sandoz brand of generic Lotrel look exactly the same as trade name Lotrel? I know that GSK probably doesn’t do this yet, but when they do, will you still be pushing some new-product-x and bashing the generic when you fully know that the generic is made by YOUR company?
Seriously, how many free trips/dinner/fancy pens/lapdances/kickbacks/bribes/”incentives”/”rebates” do you bring to cardiologists to push your new drug? Do you just throw a bunch of studies in front of him, recite some numbers from a study that GSK funded showing (surprise) Coreg CR superior to God himself and throw schwag at him? Don’t you watch those infomercials on TV and wonder that maybe you are a real-life one? Don’t you believe that to practice “good medicine” the doctor needs to have a un-influenced (meaning no goodies) decision on what agent would be the best and safest for the patient found out on his own free will? If a doctor is “too busy” talk with ME, a licensed professional about his patients health and medication then why would he have enough time to talk with YOU unless you somehow benefit him with free goodies.
Do you tell him how expensive this shit is? I mean “I have this wonderful drug that will cure everything” sounds great, until you say “but it costs 34 kerjillion dollars a month”. Seriously, what doctor is going to prescribe something to a patient knowing full well they cant afford it? Oh, because you don’t tell them how much it costs. So I get on the phone, and I tell him “Uh, Mrs Smith has no insurance, and new-drug-x costs $200/month”. He/She goes “Oh, I had no idea, the detail person was just in here”. See that? By you omitting information, you just cost both of us time we did not need to waste.
So I want you to do something. I want you to take a few hundred bucks, and throw it away every month for no reason. Then you’ll see what its like to have no insurance and have your Doctor refuse to switch from Coreg-CR because of someone like you.
Told ya I didn’t like drug reps. Im sure you’ll get some colorful comments from other pharmacists who share my view.