Bad news for generics

The Association of Healthcare Journalists just released their award-winning stories for 2009.

I've been working my way through them, but was particularly struck by Katherine Eban's story Bad Bargain about the lack of FDA oversight for generic drug production, much of which is done outside of the U.S. The story appeared in SELF magazine.

I am an avowed proponent of generic medicines and had only heard of problems with the drugs one other time from my new endocrinologist.

He said generic forms of Synthroid (prescribed to people who's thyroid gland has stopped functioning)can contain 40 percent less of the active ingredient than Synthroid. He actually asked me to switch! I wrote him off as someone who regularly golfs with pharmaceutical reps, but reading Eban's article last week put me on the hunt.

But the most recent article I could find was based on an email survey sent to 18,000 members of the American Thyroid Association, American Association of Clinical Endocrinologists, and The Endocrine Society.

Although the authors didn't report how many of their colleagues wrote back (at least in the abstract), they only found 198 "adverse events" associated with generic Synthroid--177 reported when a patient switched from brand name to generic and 52 from one generic pill to another.

I'm not too concerned. It's my thyroid. It gets checked every 3 to 6 months. There are significant cost savings in question and limited risk of serious side effects.

However, if I were one of the patients mentioned in Eban's article who had arguably more serious conditions and irrefutably more serious generic-related effects (suicide being a big one), I might be pushing for the brand name.

And, I would hope to have the kind of physician who would look for those symptoms if I did switch to a generic, not like the toad in Eban's article.