Take the money and run

Lots of drugs have two names. one short and catchy and marketable and the other long and difficult to pronounce.
For example Tamiflu/Oseltamivir – the names that caught the head lines in 2009. It took me a few weeks to get fluent with oseltamavir whereas just tamiflu rolled off the tongue (and flew off Roche’s shelves and into government stockpiles). Even the name Tamiflu implies its role – it’s a drug that cures flu right?
Drug companies put millions, sometimes billions into development of a new drug and subsequently they get a patent on it. So for the first 15 years (or so) they have exclusive rights to the chemical and can charge effectively what they want for it.
This explains the huge pressure to prove that new is better. That crappy old paracetamol just isn’t up to the job, we need new drugs, and the new drugs are always better.
I’m glad we put people to sleep with propofol and not ether any more (though why we can’t use ketamine like most of planet earth I don’t know…) that was a definite step forward but I’m pretty sure the difference between omeprazole and esomeprazole is as minimal as the difference in names.
The office does a good rant on the “me too” drugs of stereoisomers.
Once a patent runs out then anyone can make the drug and sell it at a competitve price (therefore often reducing the cost by 10 times) to purchasers. These are called generics. In general (with a very few important exceptions) these are identical to the branded drugs
But for doctors time is precious and they read too many drug ads and meet too many drug reps and they tend to remember the short snappy name and not the long hard to pronounce one. So when they prescribe the drug they write the short snappy name and the pharmacist is obliged to dispense what the doctor has written. Even when the generic form costs  a tenth of the price.
The department of health, in a rare moment of common sense has decided that pharmacists should be able to automatically substitute the cheaper generic drug even when the doctor has prescribed the expensive branded version (remember these are the same chemicals, with the same effects, just with different names).
Reading back over that it kind of seems crazy that we didn’t start doing this years ago.
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July 2010
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