Sick and tired of high drug costs? You're not alone. Americans spend more than 150 billion dollars per year on pharmaceuticals, and with costs rising all the time, many are looking to generic alternatives. These products promise the same benefits as their name-brand equivalents, but at a fraction of the cost. When considering something as important as your personal health, do generic drugs measure up?
The variances between generic and innovator preparations that are used by regulatory agencies to make decisions about relative bioavailability (20-25% difference in the outer boundaries of 95% confidence intervals) are perfectly fine for most drugs that have a broad therapeutic window and a wide toxic-therapeutic ratio. For a minority of drugs, this is not adequate, and this includes antiarrhythmic drugs, anticoagulants, and anti-convulsants. Here, small differences in concentration can have disastrous consequences, and frequently do. In the cited article, electrophysiologists were able to identify clear cases in which a change in formulation was associated with deterioration in patients’ otherwise stable cardiac condition.
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