Influencia de la sustitución de medicamentos de marca por genéricos en el cumplimiento terapéutico de la hipertensión arterial y la dislipidemia

Abstract

In patients receiving amlodipine or simvastatin, compliance decreased with time, independently of the change from a band name to a generic drug.

Comparative effectiveness and costs of generic and brand-name gabapentin and venlafaxine in patients with neuropathic pain or generalized anxiety disorder in Spain

“…However, it has to be said that without adequate standardization of methods in terms of patient characteristics, and the number and extent of the variables studied, the results should be interpreted with caution and we must be conservative about the external validity of the results as the study was carried out in a local population setting only. Furthermore, although previously reported in the literature, 15 , 33 , 37 , 39 , 40 the poorer treatment adherence observed with the generic compared with the brand medications in this study translated into poorer outcomes in the clinical variables, with decreases in pain and symptoms of anxiety significantly larger with the brand than with the generic.…”

“… 32 We should also be aware that, in addition to the known reasons for noncompliance or lack of adherence to drug treatment, which may be “intentional” (sociodemographic factors, side effects, drug prices, lack of understanding of treatment or health status, etc) or “unintentional” (forgetting how to take the medication correctly, etc), the study results suggest that administration of a generic drug could be considered an additional factor. 33 …”

“…The temporal relationship between lack of adherence, lower persistence, less clinical effectiveness, and more use of health resources is beyond doubt and very consistent in the literature. 33 , 43 , 44 However, one criticism may be raised by the fact that patients receiving generics were taken more drugs in the pretreatment period both with gabapentin and venlafaxin as well. Consequently, that could jeopardize the baseline comparability of groups since it could be interpreted as certain channeling effect toward including more refractory patients in the generic cohorts.…”

Consequences on economic outcomes of generic versus brand-name drugs used in routine clinical practice: the case of treating peripheral neuropathic pain or generalized anxiety disorder with pregabalin

“…A great deal of evidence suggests that a generic drug has the same qualitative and quantitative composition in terms of active substance and pharmaceutical form, with demonstrated bioequivalence (bioavailability studies), in comparison with the reference (brand-name) medicinal product. It should be noted that generic versus brand-name drugs may differ in terms of excipient composition and outer appearance and that this may result in problems of bioappearance [16,17]. In Spain, the entry into the market of these drugs has contributed to a reduction in pharmaceutical expenditure in public health; however, at present, both generic and brand-name drugs have the same cost of acquisition as there is a reference price system [15].…”

“…However, since reference prices were established, this is no longer the case in Spain; now, generic and brand-name drugs come at the same cost to the Spanish National Health System (SNS) after loss of exclusivity period or patent protection [15]. The disadvantage of a generic drug is the confusion it may cause in patients with respect to its commercial name (active substance) and its presentation or form (bioappearance), especially in older people [14,16,17]. This potential confusion may lead to medication errors, which could in turn lead to treatment nonadherence, cause a possible decrease in clinical effectiveness, trigger the onset of adverse effects and generate a potential increase in associated healthcare costs [18,19].…”