OSPIRG study details many retail drug abuses
Americans spend $7 billion a year on
prescription drugs, an expense that might
be cut if customers could buy drugs by
their generic names, instead pf by the well
known brand name.
In a survey done last month by OSPIRG,
a Portland pharmacist said “the drug
prednisone sells for $30 per hundred for the
brand name, and $1.50 for the generic
name.”
In the Eugene area, the Register-Guard
(August 1972) documented price
discrepancies of 12 commonly prescribed
prescription drugs in 14 Lane County
pharmacies and urging customers to
compare prices. Their investigation
showed that the highest price quoted was
at least 130 percent higher than the lowest
for each drug when the brands were the
same. Some of the generic drugs were as
much as 240 percent more costly from
lowest to highest prices.
A 1971 Eugene Legal Aid Service study
and a 1973 study done by Jan Newton’s
economics class at the University found
similar price variations. Of 34 different
prescriptions at 16 different pharmacies,
By BETSY CAREN
Of the Emerald
there was a 29 percent average difference
in prices between the lowest and the
highest stores surveyed in the University
investigation
In another recent study by the U.S.
Senate Small Business Subcommittee,
Ciba’s Serpasil, often used to reduce
hypertension in the aged, sells at $65 per
thousand at some drug stores. Its non
brand competitor reserpine costs about
$2 25 As evidence that Ciba could make a
profit at the lower price, the committee
reported “the company once offered the
same drug to the Defense Department in
mass quantities for a mere 60 cents per
thousand.’’
“Consumers could save up to 36 percent
on their total drug bill if generics were
used instead of brand name drugs,"
OSPIRG survey author Ellen Rosenblum
Nelson said.
Pharmaceutical companies are in
business to make money. The U.S.
Research and Development Corporation
testified before the U.S. Senate that,
“ drug manufacturers deliberately keep
prices high and use tactics, techniques,
and strategies to perpetuate the false and
malicious arguments that drugs sold
under their generic names are unsafe.” All
drugs must meet rigid federal standards.
By law, trade and generic names are
identical.
It is a very expensive procedure for
pharmaceutical companies to reach
physicians and convince them of a given
product. The Department of Health
Education and Welfare estimated in 1968
that drug companies spend about $4,500
per physician to sell their product. Ad
vertising is so costly, that smaller firms
often cannot compete in the brand name
push
Consequently, smaller firms promote
generic name drugs. They deal mainly
with pharmacists, and thus are not able to
bring th^r low cost wares to the attention
of the physician.
A busy physician has a hard time
keeping up to date. There are some 1,200
drugs and literally thousands of drug
combinations at a doctor’s disposal.
According to HEW, “seventy percent of
currently marked drugs were either
unknown or unavailable fifteen years ago,
when more than half of the nation’s
physicians were receiving their phar
macology training in medical school.”
Frequently, physicians must depend on
a medical services representative for a
quick and often biased thumbnail sketch of
recent drugs.
Medical students are generally taught
chemical and generic names of drugs. The
chemical drug is based on its chemical
structure. For example, the chemical
name 2-methyl — 2-propyl — 1-3
propanediol dicarbonate is a precise
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identification of a compound and is
meaningful to a chemist.
However, the generic name is the
shorter one and is usually found in
scientific literature. The compound just
mentioned is known generically as
mebrobamate.
The brand or trademark name is used by
a company to distinguish its product from
that of a competitor, which may contain
identical ingredients. A company can
select any brand name it wants, and
usually chooses one that is easy to recall.
For example, the tranquilizer
mebrobamate has different brand names.
One company has named it Miltown and
another Equanil
The physician must decide whether to
prescribe by generic or brand name. Many
physicians will issue the brand name drug
over the generic because it is easier
remembered and better known.
The consumer often has no choice but to
buy the more expensive products because
of “anti-substitution” laws in effect in
almost every state, including Oregon. This
law does not allow pharmacists to fill a
prescription with a “generic” drug, when
the prescription designates a particular
“brand name” drug.
These “anti-substitution” laws were
introduced to combat a rash of counterfeit
prescription drug products on the U.S.
market following World War II. The
pharmacists and the drug industry backed
the passage of these laws. Counterfeiting
has been suppressed since the passage of
the laws, yet drug companies still main
tain there is a need for “anti-substitution”
laws.
Rosenbloom-Nelson stated, “It is ap
parent to anyone familiar with the
marketing system of large drug com
panies that brand substitution is a threat
that strikes the very heart of the system.
The five thousand dollars spent per year
for each physician on promotion of brand
names is designed to convince the
physician that brand name products are
superior to their generic counterparts and
to imprint on his mind the catchy brand
name of the drug.”
Therapeutic equivalency in the sub
stitution controversy also needs to be
considered. Will two chemical equivalents
produce the same clinical effects? As a
measurement of these effects,
bioavailability, which denotes the relative
amount of the drug absorbed or the ef
ficiency with which a drug is absorbed, is
estimated. Two drug products have the
same therapeutic effectiveness, if they
have the same bioavailability.
“Large differences in bioavailability
from one product to another have been
reported for a few drugs,” said Mike
McClain, Secretary of the Oregon Board of
Pharmacy.
The experience of the FDA indicates
that there is no major difference between
generic drugs and their brand-name
equivalents, in many cases.
“Based on many years of experience
with this program, we are confident there
is no significant difference between so
called generic and brand name antibiotic
products on the American market,” FDA
Director Henry Simmons stated.
The American Pharmaceutical
Association’s White Paper concluded, with
regard to therapeutic equivalency,
“Comparable drug products that meet the
official standards and specifications are,
for practical purposes, therapeutically
equivalent in all but a relatively few
cases.”
A consumer is not entirely helpless. If a
consumer is aware, he or she will find that
the prices of drugs may vary greatly from
place to place. The OSPIRG report stated,
“Consumers can save up to 42 percent on
drugs, just by shopping at the right
pharmacy.”
Consumers can ask their physicians to
suggest the generic drug instead of the
brand, name drug. Generic drugs are
cheaper and often have the same
therapeutic effect as brand name drugs.
The law does allow a pharmacist to fill a
generic name prescription with a brand
name drug. Many pharmacists will fill the
prescription with a brand name drug and
charge the consumer the higher price.
Other physician’s practices include: The
use of a prescription blank with a phar
macy name on it; or a suggestion that the
consumer should go to one particular
pharmacy. A consumer confronted with
these practices should inform a local
medical society.
In some cases, a physician may ask the
name of the patient’s pharmacy and call in
a prescription. This is an ethical practice
often used to save time.
Price comparisons can be done by phone
by the consumer. OSPIRG recommends
that the consumer obtain a copy of his
prescription from the doctor in order to be
aware of the nature of the prescribed drug.
Housing Office asks dorm residents to
watch out for thieves, quit stealing
Facing a financial crisis, the University
Housing Office is urging students to help
crack down on an unnecessary expense —
theft.
The office has asked the students to
cooperate by reporting all thefts from, or
thieves in, the dormitories and has urged
students to quit stealing silver and dishes
from the dining rooms.
The response, at least to the first
request, has been good, said Dick Romm,
assistant director of the Housing Office.
He cited a case in which the University
recovered four boxes of wood stolen from
the dorms because a resident reported the
theft.
Wood has always attracted thieves,
Romm said. “A lot of people know where it
is and don’t think so much about stealing
from an institution. But it’s our wood — the
students’ wood — and it’s their money we
have to use to replace it.”
Any theft, wood or not, involves the
Eugene Police. The thieves can be charged
with a felony down to a second degree
misdemeanor. “In any case,” Romm said,
“we will take action.”
The Housing Office’s financial crisis
stems from rising food prices. The office
anticipated a seven percent increase in
raw food costs over the past year. They
budgeted for a 10 percent rise. But food
costs for October soared to 30 percent
above last year’s October costs.
To compound the problem, the dorms
are housing 90 fewer students this quarter
compared to last spring quarter.
Besides the theft crackdown, the
Housing Office hopes to lower costs by
lowering the amount of food wasted on the
dorms’ food trays.
The office circulated a letter in the
dorms at the first of the year asking
students to cut down on wastage on food
trays. The wastage up to November had
dropped from last year’s figure, Romm
said, but it is creeping up again.
“We are really trying to find ways of
reducing expenses without reducing
services,” he said.