In a letter, a neurologist told me: "Dr. Michael Wilkes has done patients everywhere a gross disservice when he tells them that generic medications are 'just as good' as their brand-name prototypes."
Generic drugs sell for a fraction of the cost of trade-name drugs and allow many people to take drugs they otherwise could not afford.
In fact, the Food and Drug Administration insists that generic manufacturers prove that their generic drug has the same properties as the trade-name drug.
A major flaw of U.S. pharmaceutical research is that, for the most part, drug manufacturers fund studies looking at a drug's effectiveness.
This clearly makes no more sense than allowing auto manufacturers to provide the studies on car safety or permitting mine owners to conduct audits on mine safety.
The profit motive in selling drugs is such a strong driver that bias can creep in through every scientific pore. Drug companies that fund the studies own the research and can choose to release only studies favorable to their product.
Pharmaceutical companies have a huge profit incentive to demonstrate that their brand-name drug (e.g., Synthroid) is better than the lower-cost generic (levothyroxine). In the case of Synthroid, a drug commonly used to treat thyroid disease, the manufacturer went so far as to sue the researcher at the University of California, San Francisco, hired by the company to conduct the comparison study.
Why? She tried to tell doctors the truth – that the drugs were the same.
A recent article in the Journal of the American Medical Association is the latest to suggest that generics are every bit as good as trade-name drugs.
In the JAMA study, experts reviewed research comparing generic heart drugs to the trade-name drugs and found no clinical differences. Yet when journals asked expert doctors for their opinions, more than half of them felt generics were inferior.
On the surface, one might assume that these experts know something that other doctors don't. However, it is more likely that many of those writing these medical editorials trashing generic drugs have strong financial relationships with the trade-name drug companies.
So the next time your doctor writes a prescription for a generic drug, rest assured that the drug is every bit as good as a trade-name drug, costs a lot less and has been around long enough for us to know about the drug's dangers and side effects.
Michael Wilkes, M.D., is a professor of medicine at the University of California, Davis. Reach him at drwilkes@sacbee.com.
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