Coumadin vs generic warfarin

[Ross]

And some insurance companies will cover Viagra, but not birth control.

Al, is there any place I can get your Barr labs info in writing to take to my cardio?

Here is a start:

http://www.barrlabs.com/generic/approval.php

In order to be deemed therapeutically equivalent to brand products, generic drugs must have the same active ingredients, same dosage form, same standards for purity and quality, same standards for manufacturing, and same amount of drug absorbed over the same time as the equivalent brand product. Generics are also required to meet the same stringent government standards for strength, purity and potency as the brand version.

Under this process, the generic manufacturer uses the safety and efficacy data supplied by the brand company, and must only prove to the FDA that its generic product is equivalent to the branded product. The FDA does not require the generic company to conduct separate and complete clinical studies for safety and efficacy because the brand drug has been used safely for many years.

 

[Guest]

Here is a Barr Labs news release from 1997. Drug companies are not allowed to make statements not approved by the FDA in these situations.

It backs my point that those who say that they are not equivalent sealed their minds against new developments at least 9 years ago.

 

[Guest]

Here is another from 1999, citing the area under the curve study.

http://www.zoominfo.com/directory/Haines_Stuart_45929337.htm

Remember that this was from 7 years ago and I'm sure Stu would be more strongly in favor of the generic today.

 

[John & Joann]

The other problem we have is that there are several different providers for the generic. Our PBM, (Caremark) will ship which ever provides the best deal for THEM this month. They are only interested in their PROFIT. Customer service is not high on their list.

If we were guaranteed the same mfg. each month, then we would push our Cleveland Clinic cardiologist.

His opinion and others at Cleveland Clinic are NOT THE SAME! It is not a Cleveland Clinic position to recommend not using generic for the coumadin.

 

[Granbonny]

First scrip my daughter picked up for me on the way home from surgery...Eckerd's Drug store..4 years, 4 months ago..was....Warfarin..5 mg.. (Barr)......Never knew there was a difference?.Always in range.. did come off for 1 day years ago for 2 extractions....Just tweaked it for 2 days to get back up. ..Very soft..No need to split, ect. A tweak is a tiny bite. Cost less than $20.00... Even, tho, I am on medicare. I file it along with my Hubby's b/p meds.//UnitedHealth care..About every 2 months. they always pay the entire amount. (my warfarin).... I have to do 2 papers. One for my Husbands's B/P..$200.00 a month.. and one for my little Warfarin..I think..$19.00?.........a month...and many including myself pay more than that for Pet food. a month. Bonnie

 

[Guest]

I still maintain that nobody has ever published even one case report showuing that even one person has ever been harmed by switching generic warfarin from different manufacturers. It seems to be one of those urban legends that has been repeated so many times that it became truth. My guess is that there are fewer than 50 doctors in the US who regularly follow the updates on warfarin that are abstracted by the National Library of Medicine. I base this on two things: 1) the doctors who are at national and international meetings on the subject and 2) the sloppy opinions that I come up against as an expert witness in warfarin litigation.

 

[Granbonny]

Al

Al

sounds like a good survey..Poll? I will start...4 years 4 months on Warfarin..Barr.5 mg. No problems. bonnie

 

[temp69]

my warfarin anecdote

my warfarin anecdote

inr went from around 2.5 - 3 to 3.9 when I switched to Warfarin because Medco mailed it to me. coumadin clinic guy said to not worry, just eat some more greens and he's see me in a month. mmmm....

don't know if the warfarin caused the rise, but i was pretty consistent on coumadin, but i'm only two months post op so I'm just guessing. will post later when I've been on the stuff for months, not weeks.

 

[catwoman]

My PCP told me I'd probably see a change when I switched to warfarin from Coumadin. But -- that since I home-test, I'd know pretty quickly if there was a change in my INRs and that we'd adjust my dosage as needed.

There was no change whatsoever.

My guess is there's probably something else going on in your case, other than a switch from Coumadin to warfarin.

When my INR drops or jumps significantly, I reflect about possible changes in my diet/exercise level/meds/health, etc. I jot those down in my INR record booklet. I also record when I recharge my ProTime 3 battery, start a new batch of cuvettes.

 

[Ross]

Man we rehash this subject so much it's not funny. There is NO difference between Coumadin and Warfarin except price paid for brand name vs generic. Same ingredients, same strengths. If something is off in your INR after the switch, it's not because of the switch, but something else.

 

[Guest]

Another doc who gets most of his/her continuing education from sales reps.

 

[RCB]

Another doc who gets most of his/her continuing education from sales reps.

While I have experience no difference in meds, even though I was told by several drs. I would, perhaps this women may be the exception:

http://www.ptinr.com/data/templates/article.aspx?a=323&z=17

Is she just seeking attention or is there any medical proof to her assertions?

P.S. Tip-of-the-hat to Lynlw for the url reference from another thread.

 

[jeffp]

Another doc who gets most of his/her continuing education from sales reps.

I got lots of continuing education from sales reps Cheap CE credits, and you always got a real nice fancy meal to boot, sometimes even some cool trinkets Last one I went to I got a neat pen with a laser pointer in the back end. The cat loves to run around the house chasing after the dot Seriously, I think we all take the sales rep CE with a grain of salt. Way back, generics were less predictable than proprietary brands and many docs still think that's the case, not that sales reps do anything to disclaim that notion. I had sales reps that would just plain make up stuff to get you to use the product; those that do, usually didn't last long.

 

[Blanche]

There are several reasons why people might want to use Coumadin rather than the generic. I don't believe there is a difference, but I say "live and let live!!!" Our cardiologist and all 13 fellow partners in his practice advocate the use of Coumadin over generic, as does our internist, Al's neurologist and his neurosurgeon who is from Barrows Neurological Center.

Albert has numerous problems and with age I have developed many, including a-fib which means that I too take Coumadin now. With the verious ailments that we have, I just plain don't think that the Coumadin/Warfarin issue is one for us to mound up the dirt and stick in the flag. But, the difference in cost for us is about $40 a year for each of us. If it were more, it might be a different story.

Blanche

 

[RonP]

Coumadin Vs. Wafarin

Coumadin Vs. Wafarin

I too was told only to use Coumadin and not to let the insurance company substitute Wafarin for Coumadin.

 

[Guest]

Another doc who gets continuing education from the marketing department of drug companies.

 

[RonP]

Thanks Al

Thanks Al

This I'm finally learning. I'll have to also change to wafarin.

 

[Guest]

Here is another way of how this don't switch tactic was worked
You have heard of "bait and switch", well this was the bait and don't switch tactic.

For many years all strengths of warfarin were sold to hospitals for 1 cent per hundred tablets. Meanwhile the sales reps were told to call on doctors saying that is they were having trouble getting the INR stable, it was probably because the patients had switched to generic. If you hear a lie often enough it becomes the truth! (ie war in Iraq)

Doctors at prestigious places like Barrow's Neurological are faced every day with life and death brain cancer etc decisions. You really can't expect them to give too much thought to the pressing problem of generic warfarin. Their time is limited so it is the easy way out to go with what the sales rep says. End result, nice $$$$$$$$ for the Coumadin makers.

If the docs had time to read the studies about generic warfarin, they would find that there never has been a published study showing superiority for Coumadin. Indeed there have been some showing that generic was slightly better.

Therefore, my conclusion that these docs get their CE from sales reps.

 

[catwoman]

I went to myuhc.com to compare prices for Coumadin vs. generic in 1mg, 2mg & 10mg, the sizes I order. I take 6.5, very occasionally a little more, daily of the generic & a bottle of 90 of each lasts me 6 months. And, yes, you can do this, order double strength and break the tabs. My PCP writes the Rx "use as directed." These prices are all mail-order. Prices would be higher purchased retail, 30 tabs at a time.

1mg of brand-name, 90 tabs = $46.73
2mg of same = $48.61
10mg of same = $63.54
Total = $158.88

I order generic, $20 each Rx, for a total of $60. Order twice a year for a total of $120.
If I got Coumadin, I'd be paying $317.76 a year.

If I ordered regular dosage (for 6.5 mg), Coumadin brand, 90 tabs:
2.5mg = $49.75
4mg = $49.45
Total of $99.20 X 4 = $396.80.
To have a little extra on hand for the occasional tweaking, I'd need at least a bottle of 1mg's ($46.73). That would be a total of $443.53.

If I ordered 2.5's & 4's of generics X 4 times a year, that would be $160. It'd still need an occasional bottle of 1's, which would raise it to at least $180.

$317.76 or $443.53 (or $180) a year vs $120? It's a no-brainer.

When my doctors cough up the $$$ for my meds, I'll buy name brand. But I saw no change whatsoever when I went to generic.

Other than to my checking account.

 

[catwoman]

Doctors at prestigious places like Barrow's Neurological are faced every day with life and death brain cancer etc decisions. You really can't expect them to give too much thought to the pressing problem of generic warfarin. Their time is limited so it is the easy way out to go with what the sales rep says. End result, nice $$$$$$$$ for the Coumadin makers.

Al:

Those sales reps wine & dine medical professionals at conventions, offices, meetings, etc. My vet friends & their employees get this treatment too.
It's the same with other businesses. My cousin works for a water-purification system company in Houston, not far from the IAH airport. She said one of the secretaries was being wined, dined & lodged by various hotels in an effort to get the company's business when it brings in clients & employees from other locations.
I'll bet companies that make generics don't spend nearly as much on promoting their products.
(Geez, I must be missing something here. When I book a hotel for use by a cat club for its judges and exhibitors, I visit 4-10 hotels/motels. Never gotten a free meal.)