The Seventies were fun, they were grand and we loved them…Remember Kiss, the Bee Gees, tie-dyed shirts, and love songs?
Well, a group of Harvard scholars thinks the seventies is where it is at, and if it were up to them, patients would only have access to pharmaceuticals developed during that period.
A generic drug needs to be understood as a therapeutic ideal built on market and regulatory practices that evolved over the 20th century, said Jeremy Greene, Harvard Medical School Instructor in Medicine at Brigham and Women’s Hospital and Assistant Professor of the History of Science at Harvard.
(Therapeutic Ideal? Is this supposed to mean that we should evolve to an all-generic formulary? If so, product innovation would cease.)
This was the theme of a recent interdisciplinary conference of sixty faculty members held at Harvard, “Unbranding Medicine: The Problems, Politics, and Promise of Generic Drugs,” by the Harvard Interfaculty Initiative on Medications and Society.
This summary of the conference does not seem to take into account that even the “nefarious” practices used by the branded companies provide revenues that fund innovation.
Other equally outrageous quotes from this gathering include:
This disconnect between science and perception may be preventing the health care system from realizing the full public health potential of generic drugs. (Perhaps the guy who said this has missed out on the $4.00 generics at Wal-Mart.)
Generics now make up about 65 percent of all prescriptions filled but a mere 10 to 15 percent of national pharmaceutical expenditures. The attendees fail to understand that the discrepancy arises logically from the fact that branded drugs are priced to recover the far greater developmental costs – without which generic drugs would not exist. They work as well as their name-brand counterparts and even better in some situations. Many drugs work the same but not on the same people, also most drugs are approved on bioequivalence so they may not have tested better, but for the most part, newer drugs have fewer side effects than older drugs – hence drug development.
Yet, despite evidence of their effectiveness, safety, and value, most doctors and patients still prefer the brand-name products. This is mostly from the fact that they work better, and have fewer side effects, but those committed to the religion of generic drugs want to convince themselves that older is better despite advances in technology.
“Science is the best guide to true actionable knowledge and is useful to cut through anecdotes and ideology” said initiative leader Jerry Avorn, Harvard Medical School Professor and owner of generics detailer Independent Drug Information Service which provides moonlighting gigs for his staff at Harvard. There is no problem with this statement except that it fully describes Doctor Avorn, who uses anecdotes and ideology to promote generic drugs.
This conference serves, as yet another example, of how disconnected academia is from the world of patient care and drug development. The seventies were great, but for my medicine, I will stick to 2009.