Generic Drugs Overview
As stated by the Food and Drug Administration (FDA) - a generic drug is
identical, or bioequivalent to a brand name drug in dosage form,
safety, strength, route of administration, quality, performance
characteristics and intended use. In other words,
pharmacological effects of generic drugs are exactly the same as
those of their brand name counterparts. Generic version of the
drug has the same active ingredient with the same chemical
purity as the brand name drug. However, trademark laws in the
United States do not allow the generic drug to look exactly like
the brand name drug. So other ingredients such as tablet
fillers, binders, coatings, flavors, or colors usually are
different.
The major difference between brand name and generic drug is the
research process required for the brand name company to
discover, design, and develop the new drug. This process
includes preclinical testing of a new drug in laboratories,
several phases of clinical studies in volunteers and people who
have the disorder being studied and finally FDA review and
approval. The whole process usually takes about 10 years and on
average can cost a drug company about $500 million.
The FDA grants the innovator company a patent that gives the
company an exclusive right to a drug for 20 years. Additional
patents can sometimes be filed to extend the patent life. After
a patent has expired, other companies are allowed to manufacture
and sell a generic version of the drug.
For the healthcare industry, generic drugs offer significant
savings to consumers. According to the Congressional Budget
Office, generic drugs save consumers an estimated $8 to $10
billion a year at retail pharmacies. Potential savings are even
greater. American consumers could have saved $20 billion in
2004, and even more could be saved in 2005 and future years,
says a report released by Express Scripts Inc.
Generic drugs are less expensive because generic manufacturers
don't have the investment costs of the developer of a new drug
and so they can sell their product at substantial discounts.
Also, when multiple companies begin producing and selling
generic versions of the same brand name drug, the competition
among them also drives the price down even further. Today,
almost half of all prescriptions are filled with generic drugs.
Before generic drugs can be marketed, they must be approved by
the FDA. To start approval process, generic company has to
submit Abbreviated New Drug Application (ANDA) to the FDA.
The main stages of the generic drug review process are the
following:
Bioequivalence Review - this process establishes that the
proposed generic drug is bioequivalent (within a few percentage
points) to the brand name drug. Generic drug is bioequivalent to
brand name drug if both the rate and extent of absorption of the
active ingredient of the generic drug fall within established
parameters when compared to that of the brand name drug.
Bioequivalence of different versions of a drug can vary by up to
20%, because for most drugs, such variations do not noticeably
alter effectiveness or safety. However, actual differences
between FDA approved generics and brand name drugs are typically
only about 3.5% on average and rarely exceed 10%.
Chemistry/Microbiology review - this process provides
assurance that the generic drug will be manufactured in a
reproducible manner under controlled conditions. Among areas
that are subject to check are manufacturing procedures, raw
material specifications and controls, sterilization process,
container and closure systems.
Request for Plant Inspection - Upon filing an ANDA an
establishment evaluation request is forwarded to the Office of
Compliance to determine whether or not every link in the drug
production chain is operating in compliance with current Good
Manufacturing Practice regulations. Each facility listed on the
evaluation request is evaluated individually and the Office of
Compliance makes an overall evaluation for the entire
application.
Labeling review - this process ensures that the proposed
generic drug labeling (package insert, container, package label
and patient information) is identical to that of the brand name
drug except for differences due to changes in the manufacturer,
distributor, pending exclusivity issues, or other
characteristics inherent to the generic drug.
Based on the results of bioequivalence review generic drug
receives a two-letter therapeutic equivalence evaluations code.
The coding system for therapeutic equivalence evaluations is
constructed to allow users to determine whether the FDA has
evaluated a particular approved product as therapeutically
equivalent to other products (first letter) and to provide
additional information on the basis of evaluations (second
letter).
Drugs are considered to be therapeutically equivalents only if
they contain the same active ingredients, are of the same route
of administration and are identical in strength or
concentration, and if they can be expected to have the same
clinical effect and safety profile.
The two basic categories into which drugs have been placed are
indicated by the first letter as follows:
A - drug that FDA considers to be therapeutically
equivalent to other drugs. If there are no known or suspected
bioequivalence problems, the generic drug receives one of the
following codes:
AA - Products in conventional dosage forms not presenting
bioequivalence problems
AN - Solutions and powders for aerosolization
AO - Injectable oil solutions
AP - Injectable aqueous solutions
AT - Topical products (creams, gels, lotions, oils,
ointments, pastes, solutions, sprays and suppositories)
AB - If actual or potential bioequivalence problems have
been resolved with adequate evidence supporting bioequivalence
B - drug that FDA, at this time, considers not to be
therapeutically equivalent other pharmaceutically equivalent
products:
BC - Extended-release dosage forms (capsules, injectables
and tablets)
BD - Active ingredients and dosage forms with documented
bioequivalence problems
BE - Delayed-release oral dosage forms
BN - Products in aerosol-nebulizer drug delivery systems
BP - Active ingredients and dosage forms with potential
bioequivalence problems
BR - Suppositories or enemas that deliver drugs for
systemic absorption
BS - Products having drug standard deficiencies
BT - Topical products with bioequivalence issues
BX - Drugs for which the data are insufficient to
determine therapeutic equivalence
B* - Drugs requiring further FDA investigation and review
to determine therapeutic equivalence
If the generic drug is placed into B category this does not mean
that it is not good or is of lower quality. It simply means that
if you started using that generic, you should not switch to the
brand name or vice versa especially if that drug has a narrow
therapeutic range (some antidepressants, corticosteroid tablets,
antihypertensive drugs).
To ensure the quality of generic drugs, FDA inspects facilities
where drugs are manufactured about 3,500 times a year. Both
brand name and generic drug facilities must meet the same
standards of good manufacturing practices. FDA does not permit
drugs to be made in substandard facilities. Manufacturers of
generic drugs have facilities comparable to those of
manufacturers of brand name drugs. In fact, with the potential
to lose millions of dollars to a generic companies, some brand
name firms have either bought smaller generic companies or
created their own. FDA estimates that 50% of generic drugs are
produced is by brand name companies. They frequently make copies
of their own drugs but sell them under the generic name (e.g. GlaxoSmithKline and Pfizer produce generic
versions of their own drugs Paxil and Neurontin).
Not all brand name drugs have generic versions. Sometimes a drug
is too hard to duplicate, or there are no adequate tests to
prove that the generic drug acts the same as the brand name
drug. Sometimes the market for the drug is too small and there
is no business sense to create another version of a drug. You
can search for all generic equivalents of brand name drugs by
using the "FDA
Electronic Orange Book".