I have long been a strong proponent of generic medications. Recently, however, several of my patients have expressed concerns about the generic medications that they have received. This led me to do some research on generic pharmaceutical companies.
The first thing to know about generics is that they are made by many different manufacturers in many different countries. This is the reason that your generic medication may suddenly look quite different. In fact, pharmacies are changing suppliers for generic medications more and more often and usually not for quality reasons but rather to save some money – so that they can increase their profit.
In response to this change I began writing prescriptions that specified the brand. Doctors can do this for generic as well as non-generic medications. That said, it is hard to keep up with who manufacturers which medication is companies enter and leave the market rapidly.
Another change in the world of generic medications is the growth in the business and in business profits. It used to be that generic manufacturers accounted for a small portion of total pharmacy sales but this is no longer the case. And as the market has grown the complexity of the companies has increased as well. The larger companies have plants around the world, particularly in India and Eastern Europe.
Meanwhile there are more and more reports that the generic market is not competitive. In late 2017 45 of the state Attorneys General filed a lawsuit against most of the large generic manufacturers alleging price fixing. The situation has become serious enough that several of the largest hospital companies announced plans in early 2018 to create a generic drug manufacturing company to address pricing and supply issues.
What can the consumer to and how to make sense of this increasingly complex world.
If you’re interested in diving down into the details, the FDA publishes its inspection results. If you do is I have done, and download the results and insert them by whether or not actions were taken because of the inspection, you will discover that the most important variable accounting for the results of an inspection is not the company but the location of the plant. Unfortunately, the location of the plant is not something that you are going to know as a consumer. Teva is an Israeli company that has an excellent reputation for quality. However an increasing number of Teva products are now manufactured in India and how was Indian plants don’t fear nearly as well as other plants in FDA inspections. My land is an American generic company, however almost all of its medications are manufactured in India, and its Indian plants do especially poorly.