Does the brand of medicine really matter?
Usually, when we go to a pharmacy with a prescription, we see the pharmacist choose from various brands of the same medicine to dispense the prescribed brand (given the fact, most physicians practice brand prescribing in Nepal).
When the prescribed brand is not available at the pharmacy, we are given options for its substitution. This substitution gives a hint of skepticism to many, if not all of us, on whether or not the substitute medicine will work the same. The skepticism is valid and justified, being a matter linked directly to our health.
So let’s do some fact-checking on whether or not, the brand of medicine really matter. Whether or not, the metformin by ABC pharmaceuticals you had been taking for your diabetes differs from metformin by XYZ pharmaceuticals. In short, the answer is not much or not at all.
Generic Drug and Originator Brand Drug
Let’s get into some basics here, there are usually two kinds of drugs, one is the originator brand drug and other one is generic versions of the same. The originator brand drug is the one that was first marketed, after years of research and development, usually a patent product,. The generic versions of that drug is created by other pharmaceutical companies after the patent of the originator brand drug expires after some years (usually after 20 years). The generic medicines are, in short, cheaper versions of the originator brand drug, formulated so as to act with same efficacy, quality, stability, performance characteristics, dosage form, route of administration and intended use as the already marketed brand-name drug.
Years and years of pre and post marketing research of the originator brand drug establishes safety and efficacy profile for that very drug. Hence, generic medicines which come out later do not have to go through these rigorous testing phases.
Nepal and generic pharmaceutical market
For an underdeveloped country like Nepal, generic medicines are great tools to minimize health expenditures. At present, Nepali pharmaceutical market is crowded with generic versions of various medicines, from domestic and foreign pharmaceutical companies. So when you approach a pharmacist with your prescription, chances are, you will find many generic options of that very medicine.
As mentioned above, generic medicines already have an well established safety/efficacy profile. All generic medicines are manufactured following pharmacopoeial standards or well validated in-house methods. Regular inspections of the manufacturers and market surveillance further ensures the quality and safety of the marketed medicines. Department of Drug Administration (DDA) under MOHP regulates all the functions relating to drug including production, marketing, sales, export/import in Nepal.
Hence, it is safe to say that the Metformin by company ABC does not really differ from Metformin by company XYZ. Even if there is difference, it is not of much medical importance. Such difference can be seen within the medicine of same brand of different batches.
Exception & Conclusion
But with everything there are exceptions, it is best to not substitute the drugs with low therapeutic index, because a small difference in formulation might have a big impact on patient’s response and ultimately health. Having said all this, it is always best to consult your health care professionals specially those with chronic conditions, before substituting the brand you are used to taking.
Disclaimer: The opinions/views expressed in this article should not be taken as a medical advice. Always consult your health expert for your health concerns.
Photo: National Cancer Institute / Unsplash
References:
USFDA: https://www.fda.gov/drugs/questions-answers/generic-drugs-questions-answers
DDA: https://www.dda.gov.np/content/role-of-dda
