Colleagues
Have to agree with a lot of what Mark Campbell says......but then I have worked with Mark in the past.
One additional point on the subject of generic prescribing inhibiting development of innovative drugs. There is actually a counter-view that generic prescribing actually promotes the need for research and development by the pharmaceutical industry. The view is strongly supported within the pharmaceutical industry (despite what they say publicly) and the argument goes like this:
* Generic prescribing means that we cannot be assured of having patients on our branded drug when it comes off patent.
* Therefore we must capture market share for our drug by coming up with useful new drugs and promoting them heavily. By doing this we maximize our market share and income during the period in which our drug is still covered by patent. While our drug is covered by patent even if the GP prescribes generically it is still our drug that is dispensed so we make the money.
* As the branded drug comes within a few years of the end of the patent we try a number of strategies:
Strategy 1. Licensing agreement with generic manufacturer. License the drug to be made for us by our subsidiary generic production company. That way we start to clear our main factories for production of the next branded drug in our chain and we give our generic factory the time and throughput to shake the bugs out of their production line so that our generic company has a head start on the rivals when the drug comes off patent. This is part of the reason why most of the generic manufacturing capacity in the UK is owned by subsidaries of the international pharmaceutical industry.
Strategy 2. Develop new delivery mechanisms for the drug....we can get patent extensions on the delivery mechanism (e.g. modified release, nebules, spinhalers, rotacaps, patchs, dermal pellets, large furry green things to stick in your ear etc.....
Strategy 3. Find new indications for the drug.....this might help us win a patent extension for the product
* As a company if we merely develop "me-too" products or sit on our arses and don't innovate we die.
* Therefore we must innovate to survive
I stress this is not just me speaking.......this is from very senior people within the industry
Prescribing should not be based on cost alone
But rational prescribing is guided by safety, efficacy, benefit, appropriateness, ......and cost.
I see myself as my patients advocate and their objective guide to healthcare. I consider we do them an immense disservice and squander some of their limited healthcare budget if we do not consider cost as one of the criteria guiding our prescribing.
I do agree that rational prescribing may be more expensive, but it is a justifiable expense.
Best wishes
Jim
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