There has been a lot of discussion recently in the news about this topic. As a licensed physician and avid blogger, I must weigh in on this topic. Is there a difference between Fluoxetine and Prozac. Although these drugs are “supposedly” the same there just has to be some differences or the prices would not be so drastically different.
First, I must disclose to you that 1) I do not prescribe generic drugs. 2) I only prescribe drugs that I have a firm understanding of and a clear/concise understanding or the pharmacology and 3) I do not work for any pharmaceutical companies and I certainly don’t get kick-backs. It is important to give these disclaimers at the beginning of the discussion because a thwarted view by a physician is just as bad as some of the advertisements put out by the major drug companies. I will share that I do occasionally participate in non-branded marketing research for some of the major categories of psychotropic medications. The stipend for this activity is minimal are rarely exceeds $300.00 for 1-2 hour sessions.
I do not prescribe generics for several reasons. The first reason is, “I am not sure that the chemical composition is a 100% identical to brand name drug that I have clearer fund of knowledge. Now it is true that in medical school we are trained first on the generics. However, with the modernization of research laboratories and new developments in pharmacology, the newer agents have, in my opinion, proven to be more efficacious than many of the generics. Now, I basically speak from my experience as a clinician. I have had several patients request the generic formulation of their drug and they end-up returning not many days hence, because the generic is not as effective. Also, you never know where some of the generics come from at this time. I have seen some from Canada, Australia and even Brazil. I do know that we have a FDA here, but I am not sure of the regulatory bodies in other countries.
As a practicing physician, it is important to have a very good understanding of the drugs that I am prescribing. I should know the efficacy, half-life, and side-effect profile of all the medications that I regularly write for in the office. This information is usually readily available for most brand name drugs. In my office, I generally wrote that prescription for brand name drugs, but I never check brand-only. With this, this allows the patient to decide whether or not they want to purchase the brand or generic formulation of the prescribed drugs. I am also mindful that most generics cheaper. However, cheaper is NOT alway better or as efficacious.
It is also important to note that the FDA requires that all Pharmaceutical Companies disclose all scientific data associated with there drugs. They must disclose all side-effects and more importantly BLACK BOX WARNING. a black box warning is usually a side-effect of a particular drug than can be fatal. (suicide, fetal abnormalities, hepatic malfunction).
Also, the FDA requires package inserts of the drugs that they improve. Oftentimes, the information is very detailed and above the 5th grade level, but it is still mandatory that they disclose all information, both the good and the bad associated with there particular drugs.
In conclusion, I prefer to write for brand-name medications because their is an abundance of clinical information usually readily available about the chemical composition, drug efficacy and side-effect profile.
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