For me there are positives and negatives to this type of move. The small mom and pop stores are supporting local jobs in some cases. In other cases where the product is mass produced overseas, I would prefer the lower priced Amazon Basics product.
CVS a pharmacy in my area does something like this. The slot on the shelf for the brand name product you want is usually empty. The generic CVS brand of that same product is fully stocked right next to it. I sometimes just go to a non-chain pharmacy just so I can get the brand I want.
Bioequivalence and pharmaceutical equivalence are different.
It's true that generic drugs have the same active ingredients in the same dosage and form, and they're tested to have the same general absorption characteristics. This does not necessarily mean that a brand drug and its generic version are completely identical. For example, many patients prefer Synthroid (a brand-name synthetic thyroid hormone) over levothyroxin (its generic equivalent). The inactive ingredients sometimes affect how a drug's active ingredients behave within an individual, and these are allowed to differ between brand and generic drugs.
This usually doesn't matter; most of the time, brand drugs and their generic versions are close enough. However, generic drugs aren't exactly just a different label on the same medicine, and the differences can be clinically significant. Thus, the medical world has the ability to specify "dispense as written" on prescriptions and on the corresponding insurance claims.
My wife had this problem; she took Neoral, a brand-name immuno-suppressant, for many years. CVS, especially their mail-order-specialty pharmacy that my insurance plan forced us to use, kept trying to substitute generic cyclosporine. The problem is that she learned years ago that the generic didn't have the same effect at the same dosage, putting her transplanted liver in jeopardy. Yet month after month, no matter how often her doctors intervened, CVS kept trying to send her the generic.
Last year her transplanted liver failed. She was lucky to get another one; she barely survived and she's still recovering. She's on a different immuno-suppresant now, which the hospital arranged for her to get from an affiliated transplant-specialist pharmacy in NY. CVS' horrible service wasn't responsible for her liver failing (transplants don't last forever) but the incorrect medication and missed doses definitely took its toll, and cost us a lot more than it should have when we had to pay out of pocket to buy emergency doses in-store at whatever pharmacy would supply them.
I wonder if the best way to get them to change though, isn't to sue for damages suffered from their deceptive business practices.
It's also definitely a licensing issue for their pharmacists. If they can't store and handle customer records (special needs, interactions, etc) they shouldn't be in business.
It's pretty much impossible to gather the resources needed for a lawsuit against a huge corporation that's got health insurance companies in their pocket, when you're trying to acquire the drugs needed to not die this week.
FDA doesn't seem to make this distinction. They print "FACT: FDA requires generic drugs to have the same quality and performance as brand name drugs." in bold type here[0]. Perhaps 'dispense as written' is better put as 'dispense in a way that I get some sweet pharma kickbacks'.
Agreed; my point is that the FDA doesn't make that distinction. The FDA's definition of "same performance" is close, but it's not always close enough.
(I once worked on a system that had to special-case pricing for Synthroid specifically because the FDA-approved generics aren't quite the same to a lot of people, and I ended up marrying someone who gets moody when the pharmacy gives her generic Synthroid by mistake.)
Perceived reputation, color and packaging plays a big role in perceived drug efficacy[0], I wonder if a double blinded trial would show the same results you have seen anecdotally.
I'd be interested to see results from such a trial.
Closer to home, we twice found out that the pharmacy gave her a generic when she developed quirks 4-5 days after she started taking a new bottle. Sort of the reverse of a placebo effect -- she thought she was on the brand all along, and she didn't think to check until things didn't feel right.
Not OP but I see it for many different types of items. Think bandages, ankle wraps, mouth wash, antacids, OTC pain relievers, etc.
You might say that antacids and OTC pain relievers are drugs, and that's fair. But there are other concerns besides the active ingredients. For example, I might prefer the taste of Tums to CVS brand. Or for a personally-true example, I used to find the CVS brand ibuprofen gelcaps to have a funny, sour smell that I didn't notice with Advil. (I don't notice that anymore.) Or my grandmother used to buy a specific brand of some contact lens cleaner (can't remember which), because she found the top much easier to open. The point is it's not always about the efficacy of the drug; sometimes it's about the overall experience.
The medical ingredients are identical. Everything else may or may not be. You might want children's medication in a given flavour, or the "fast acting" delivery mechanism that may not be available in the generic format.
I've noticed this issue too. Some people prefer to use a brand like Tylenol instead of the store brand acetaminophen. But the store will just not keep the Tylenol stocked to force you to by their brand.
They are both the same acetaminophen. However, I do notice that with some meds the store brand isn't an equal because they don't make the gel tabs I prefer (because it's more fast acting than the chalky white tabs), specifically talking OTC allergy meds
CVS a pharmacy in my area does something like this. The slot on the shelf for the brand name product you want is usually empty. The generic CVS brand of that same product is fully stocked right next to it. I sometimes just go to a non-chain pharmacy just so I can get the brand I want.