Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
The Opinion of The Selective Few vs.
The Good of The Infected Many
Generic Drugs Save More Lives At Lower Cost
While it may well be the perception of the physician that his
prerogative entitles "branding" to be adhered to in prescriptions, it is
the right of the community to demand that their rights to affordable
treatment in the form of generics be upheld.
Insofar as qualifications required to make such an evaluation, many
physicians are not more qualified as pharmacologists or program developers
than laypeople and governments. Indeed, many laypeople have a complete
understanding of the structure and efficacy of treatment algorithms.
Algorithms after all are logical and not medical.
It should not be assumed automatically that a "name-brand" vs. "no-
name" drug substitution plan designed by laypeople and governments with
the goals of benefitting the majority would not be superior to that of the
opinion of a small group of physicians who insist on branding in the name
of quality assurance.
What physician is an expert in quality assurance and manufacturing?
That is the realm of the layperson.
Further, governments employ knowledgeable physicians to advise in
decisions of drug choices, so physicians are well represented in such
decisions. The only possible benefit of branding in many cases is to the
shareholders of drug companies who distribute branded products.
I have often said that the patents of drugs should only be issued for
a cure and not merely for a treatment, and then only to recover the costs
of what is a fair incentive.
I would rather be healed by a nurse using inexpensive generic drugs
than to die or to deplete the resources of the system by waiting to see a
busy and expensive physician who presribes a drug that neither I nor
anyone else can afford without hardship.
By a layperson's perspective, why drive a mercedes when a bus will
carry more people for the same cost and a bicycle may be all that we need.
Traditions must change and they must change quickly for the good of
the many, including the physician.
The physician has no inalienable right that the people do not allow,
and the people are the government. If the people decide that drug
companies are robbing the country then the people have an inalienable
right to extract justice in the form of generic affordable drugs without
interference.
As long as the Governments penchant for generic names of drugs
remains limited to import of drugs, it seems fine.What would be very
questionable is if it starts insisting on drugs being prescribed by
generic names.Firstly it is no bone of contention that drugs with same
generic salts have different bio-availability depending on various factors
including the manufacturers capability.It is the prerogative of the
Physician then to prescribe the drug by name that he considers the best
and most appropriate, cost, at times,notwithstanding.This dispensing of
the drug by brand name cannot be left to the discretion of the chemist or
the government, niether of which is so qualified.Prescribing a drug and
prescribing it by brand name is the inalienable right of the Physician,
bestowed on him by tradition in the form of the Rx.It can not be ignored
or just wiped off by a stroke of Government legislation
Re: Use of generic names in clinical practice
The Opinion of The Selective Few vs.
The Good of The Infected Many
Generic Drugs Save More Lives At Lower Cost
While it may well be the perception of the physician that his
prerogative entitles "branding" to be adhered to in prescriptions, it is
the right of the community to demand that their rights to affordable
treatment in the form of generics be upheld.
Insofar as qualifications required to make such an evaluation, many
physicians are not more qualified as pharmacologists or program developers
than laypeople and governments. Indeed, many laypeople have a complete
understanding of the structure and efficacy of treatment algorithms.
Algorithms after all are logical and not medical.
It should not be assumed automatically that a "name-brand" vs. "no-
name" drug substitution plan designed by laypeople and governments with
the goals of benefitting the majority would not be superior to that of the
opinion of a small group of physicians who insist on branding in the name
of quality assurance.
What physician is an expert in quality assurance and manufacturing?
That is the realm of the layperson.
Further, governments employ knowledgeable physicians to advise in
decisions of drug choices, so physicians are well represented in such
decisions. The only possible benefit of branding in many cases is to the
shareholders of drug companies who distribute branded products.
I have often said that the patents of drugs should only be issued for
a cure and not merely for a treatment, and then only to recover the costs
of what is a fair incentive.
I would rather be healed by a nurse using inexpensive generic drugs
than to die or to deplete the resources of the system by waiting to see a
busy and expensive physician who presribes a drug that neither I nor
anyone else can afford without hardship.
By a layperson's perspective, why drive a mercedes when a bus will
carry more people for the same cost and a bicycle may be all that we need.
Traditions must change and they must change quickly for the good of
the many, including the physician.
The physician has no inalienable right that the people do not allow,
and the people are the government. If the people decide that drug
companies are robbing the country then the people have an inalienable
right to extract justice in the form of generic affordable drugs without
interference.
Bill Buckels
Winnipeg, Canada
Competing interests: No competing interests