kind of a surprise

[Karlynn]

Just received a new Rx for Coumadin in the mail today. They sent me the generic, manufactured by Taro. This really surprised me, because my card refused to let me go "generic" the last time I saw her. So I'm wondering if Medco just snuck that one in, or if my card has changed her mind.

 

[geebee]

Did you cardio need to send in a new prescription? If so, maybe she forgot to check the brand name only box.

I take both Taro and Barr and have found no problem but everyone is different. I would start by calling the place that filled the Rx & see what they have to say about the prescription.

 

[Nancy]

Medco switched Joe as well. But his doctor switched it back.

 

[Karlynn]

I'll give my card a call and see what she says. Truth be told, I'd like to give the generic a try, but she was the one that insisted I stay with Coumadin. I'm not sure how they contacted her since I did a refill on-line. Yes, Gina, it was a new Rx, as the year had run out on the last one.

The generic is 1/2 the cost for me.

 

[John & Joann]

Caremark told us that they had authority from the cardiologist to change to generic. The Dr. had NOT authorized and written DAW. Cleveland Clinic does NOT want Joann to use the generic. One of the issues is that they are at least 3 companies that make generic. Caremark can use whoever they desire.

We have the real stuff now that is made by Bristol Myers Squibb.

This is very controversial and all doctors and pharmacists have different opinions.

This is the ONLY issue that we have different opinions than Al.

God Bless!!!

John & Joann
Clicking in the Buckeye for 33.6 years.

 

[terryj]

My husbands surgeon and cardiologoist only want him on the Coumadin also. His PCP wrote it for generic a couple of years ago and his INR was all over the place. Back on Coumadin and it was back where it should be.I think some people just tolerate the Coumadin better.

 

[Guest]

My "humble" opinion is that there once was a difference but this is no longer the case. They all meet the same standard. A group in Canada just tested a bunch of people taking the brand for a period of time and then a generic for the same period. In Canada their medical system can track lab visits etc. There was no significant difference between what happened when people were on the brand and what happened when they were on the generic.

There has never been a study published that showed any difference.

If you read these pages you will find dozens of things that affect the INR.

Medical school professors teach "evidence-based medicine". That means look at the studies and base your practice on facts, not on "personal experience" because that is the least unbiased evidence.

However, when the supposed authorities in medicine come to warfarin, they ignore all of the evidence, all of the other things that can affect the INR and make a declaration using their position in world-famous clinics that it can only be the difference between brand and generic that throws things off.

Fortunately these geezers are retiring. I used to hear it almost daily. Now it is down to about once a week.

 

[catwoman]

Medical school professors teach "evidence-based medicine". That means look at the studies and base your practice on facts, not on "personal experience" because that is the least unbiased evidence.

However, when the supposed authorities in medicine come to warfarin, they ignore all of the evidence, all of the other things that can affect the INR and make a declaration using their position in world-famous clinics that it can only be the difference between brand and generic that throws things off.

Fortunately these geezers are retiring. I used to hear it almost daily. Now it is down to about once a week.

Al:
As new doctors graduate from med school, I'm sure they'll be quicker to go with generics, unless there is a very very real reason to do otherwise. Why? They grew up taking the generics, since their parents' insurance plans didn't cover the "real thing," whatever that is.
I think doctors get too ingrained with brand names because of all the advertising & media hype thrown at them. They don't consider who is having to foot their patients' Rx bills, and it isn't always 100% an insurance company.

 

[Guest]

Once upon a time I lived in a small city in Arizona. It had three pharmacies. I decided to conduct an experiemnt to see if I could do what big drug companies do - influence doctors. I was invited to speak at the medical staff meeting at the hospital. I pointed out that many patients complained about the price of the medications. Two of the three pharmacies were large chains. They would not allow a prescription to leave the store unless it was paid for. (The little guy who owned his own store might have been more generous because he went bankrupt.) This meant that if the people had limited income then they would either have to take fewer doses that ideal or let the doctor's bill go until they were pushed.

Then I pointed out how expensive many of the newer antibiotics that were being touted by the drug companies were. Then I pointed out that one of the antibiotics that had recently gone generic was available at a price that would supply ten days therapy for what two days of the newer drugs cost. I cautioned that the older drug was not quite as effective as the newer one - it only killed about 95% on the bacteria that we encountered in the hospital whereas the new one killed about 99%. I let it go at that.

About 4 days later, I went to all three of the pharmacies and inquired about the sales of the generic antibiotic. The reaction was the same at each polace. "What happened. We used to use about 100 per week and now we are using 500 twice a week." They all got a good laugh when I told them of my "experiment".

Just an example of how medical (and lots of other) decisions are influenced.

 

[Guest]

As a group, surgeons are the absolute worst medical people to ask about long-term medications. They are usually interested in "cut it out" solutions and care very little about chronic medications.

I was at a meeting once where the attendees were largely surgeons as was the speaker. The speaker asked, "If you had to be on long-term medication, who would want a surgeon managing the medications?" Not one hand went up.