Being Sick Is Very
Expensive
Daily Observer
The
miracle of medication has surely prolonged life, and in so doing, inadvertently
inflicted hardship on those of us dependent on drugs for an acceptable state of
well-being. Because
medicines are very expensive. The
government is finding out what each of us has known for a long time. Sickness is very expensive. With increasing government funding of the
American bill for health, (estimated at about 80 billion dollars, almost as much
as the defense bill) the government is looking for ways to cut costs. One way, promulgated by
The
reasoning behind this is that after the patients have run out on a medication,
its formula is open, and available to all pharmaceutical and chemical
companies. Secondary and tertiary
distributors can buy the chemical and distribute it under its generic name. Thus, Miltown or Equanil become meprobamate, Mellaril is thoridizine, Thorazine is chlorpremazine, Lanoxin is digoxin, and so forth.
There
can be considerable savings in substituting the generic product for the brand
name substance. The only problem is that
the company that produced the brand name product and took out the patients, and
invested millions of dollars, is one of an infinite number of reputable
companies, whose experience with governmental agencies has so sensitized them,
that they continually test and retest their products. They measure shelf-life, bioavailability, sterility and
numerous other factors.
Doctors
tend to prescribe brand name drugs in many instances because they have learned
through the years to have faith in their reliability. If something goes wrong, they can point to
the company who made the drug. If the
pharmacist is given license to substitute generics at will, it will be very
difficult to trace faulty medications.
There
are several reasons for this. First, the
pharmacist might change his distributor.
Secondly the distributor might have changed his source of
medications. The fact is that anyone can
put a label on a bottle, that really doesn’t define
the source of the material. If generic
substitution becomes law, patients will demand the generic drug, and demand the
cheaper product from the pharmacist. The
pharmacist will be forced to the open market, drug-houses will proliferate like
flies, and the quality control upon which the physician has for so long
depended, will have evaporated in the cloud of government edict.
Apparently
the patient has run out on Furadantin, made by Eaton
Laboratories. Furadantin,
generically known as nitrofurantein can now be made
by anybody and sold by anybody. True
these surveyors are fully licensed, but there are not enough government
inspectors to keep track of the numerous by-ways and pathways in the forest of
chemical produce and distribution.
Eaton,
of course, is upset at the competition.
Its prices for nitrofuantein are considerably
higher than those charged by generic wholesalers, probably because it has high
overhead, much of which is devoted to producing the product under quality
conditions and to maintain a continued surveillance on production and
degradation of the formulation; and also, because tax-law makes it prudent to reinvest
profits into research so that other drugs as excellent as Fruadantin
can be produced. For whatever the
reason, however, Eaton has sent out a flyer, which is a copy of a brochure put
out by the Food and Drug Administration, called FDA Report of Recalls. It makes interesting reading.
In
brief:
Nitrofurantein tabs; made by Rachell,
recalled because of sub potency.
Chorienic gonadeptrophin;
Hallmark; Labeling error.
Lidecaine HC1 Injectable; USP; by
Preme Pharmaceutical Lags; Labeling mix-up
Nitrofurantein tables; USP; Caribe
Chemical Co.;
Medicated Bandage; Sterile; McClinteck’s
Lab; Non-sterile.
The
list continues with more of the same.
There is subpotent digitalis, aminiphyllin that fails the dissolution test, injectable hydrocortisone that failed tests for sterility,
and baby shampoo contaminated with pseudomonas aeruginosa
bacteria.
Perhaps
Eaton has excluded some of the recalls, or omitted recalls from well-known
companies. It is possible. But the point is, that if generics
proliferate and the physician’s right to prescribe that which he believes to be
best for the patient is denied, federal agents the size of an army will be
required to track down medications that may be inadequate for the job they are
intended to do. The cost of the army of
inspectors alone will probably drive the cost of the medication up to its
original brand-name cost. The government
is setting free forces that it may not be able to control. The public should beware of this gamble, and
the best way to protect itself is to inform itself.