By Jonathan D. Rockoff , Sun reporter|June 17, 2008
WASHINGTON — WASHINGTON - Patients in Maryland and other states could face higher costs and delays getting prescriptions filled if a new push by major drugmakers to curb sales of generic drugs wins out, according to health officials and pharmacy specialists.
Large pharmaceutical companies have been waging war against inexpensive generic drugs for years at the national level. Now they are taking their fight to the states, promoting proposals that would mean pharmacists could no longer automatically replace certain brand-name drugs with no-name counterparts.
The state legislation could result in long delays filling prescriptions at the local pharmacy and undermine a key effort to restrain health care costs, opponents and independent specialists say.
Measures favorable to the major drug companies have been considered by 27 states and approved by two - Utah and Tennessee - over the past year, according to the National Association of Chain Drug Stores, which opposes the changes.
"It's putting a fix to a problem that doesn't exist," said Lawrence M. Brown, director of the Center for Medication Therapy Management at the University of Tennessee Health Science Center.
By law, only the federal Food and Drug Administration can certify that a generic drug is safe enough to take the place of one with a brand name. Once that happens, states can give local pharmacists the power to substitute a lower-priced generic drug when a patient presents a prescription, unless the prescribing doctor orders the brand-name medicine. Nearly all states give pharmacists that option or require them to make the switch.
Generic substitution is a pillar of efforts to hold down health care spending, with studies estimating yearly savings of as much as $20 billion. The FDA has said repeatedly that generic drugs are safe and effective, and that brand-name drugs and their generic substitutes are equivalent and have the same effect on patients. But big drug companies say the common practice of substituting generics can cause harm. Even slight changes in formulation or manufacturing can cause side effects, they say.
The legislation being pushed at the state level would make the exchange more difficult by requiring pharmacists to inform doctors or get their permission before substituting a generic version of the drug.
