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  • #16
    Re: Medicines Shortage

    Originally posted by Naughty Nigel View Post
    If the product is to the same formula the same there should be no need to retest or retrial it, but it would appear than some generic manufacturers like to cut costs by cutting active ingredients.
    Then surely it becomes a different product, should have a different name because the ingredients and be re-tested to ensure it will do the intended job correctly.

    Comment


    • #17
      Re: Medicines Shortage

      Originally posted by DavidB View Post
      My GP's surgery has it's own pharmacy and they're constantly telling me they "can't obtain" various medications which I have on repeat prescription, but the local Tesco pharmacies, etc., etc. have no such problem and say there's no shortage, but the surgery is reluctant to issue prescriptions so I can obtain my meds elsewhere.

      The problem appears to be not one of availability, but availability at a price where the GP's practice can make a certain level of profit.
      I don't think it works quite like that David. The cost of prescription medicines doesn't affect the GP's 'profit' as such, but the local health trust will have a budget for drugs which presumably they like to stay within.
      ---------------

      Naughty Nigel


      Difficult is worth doing

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      • #18
        Re: Medicines Shortage

        Originally posted by Keith-369 View Post
        Then surely it becomes a different product, should have a different name because the ingredients and be re-tested to ensure it will do the intended job correctly.
        I'm not sure about medicines, but in the case of pesticides and antifouling paints, which I have experience of, HSE registration can be by precedent (a rubber stamping exercise) provided that none of the active ingredients exceeds the concentration used in the original registered formulation.

        I am sure the situation with medicines will be different, but in the case of pesticides the authorities are more concerned about the quantities of active ingredient and their effect on humans and the environment than whether the product actually works as intended.
        ---------------

        Naughty Nigel


        Difficult is worth doing

        Comment


        • #19
          Re: Medicines Shortage

          All four of Dad's medications (all the usual things for a 74 year old) were in short supply. He'd been on them since the 90s, so they replaced them with more modern equivalents. The pleasant side affect has been, erm, less side affects (and his joints are better for it).

          That said, every repeat prescription is now an exercise in missing emails and micro management. The sheer incompetence is simply breath-taking, and this is considered the best practice in the area. In the up to the big fat China holiday, I actually sought legal advice as for liability in the event (very nearly happened) that the GP practice didn't prescribe some drugs on time* and I had to cancel!

          * And no, I had no stomach for dealing with Chinese healthcare system.

          Comment


          • #20
            Re: Medicines Shortage

            Originally posted by Tram View Post
            Also how can something that cost a quarter of the cost be the same, can't see that at all
            The company that discovered a new drug will have spent millions of pounds on it. You also have to take into account the fact that they will almost certainly have spent similar amounts on other drugs that failed one or more of the required tests and so could not be marketed.


            Companies producing only generic drugs have no such expenditure because they do no research.
            The worst camera is better than the best photographer. Edward Weston

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            • #21
              Re: Medicines Shortage

              Originally posted by Naughty Nigel View Post
              I have noticed that some batches of Amlodipine, a very common antihypertensive, cause lower leg and foot swelling. This is a known side effect but some batches are tolerated better than others. This suggests to me that it could be impurities in the medicine rather than the medicine itself which is responsible for the side effects.
              Other factors can also affect those symptoms. They can often be reduced by exercise. It is not unusual to find that patients do not have the symptoms on the day they do their supermarket shopping but do have them on the days they stay home and watch TV.


              We also need to take into account the nocebo effect. Basically, the more someone doubts the effectiveness of a generic product the more likely they are to have problems with it.
              Last edited by insider; 3 weeks ago. Reason: added another comment
              The worst camera is better than the best photographer. Edward Weston

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              • #22
                Re: Medicines Shortage

                Originally posted by insider View Post
                Companies producing only generic drugs have no such expenditure because they do no research.
                Which, providing the generic product is cheaper, has the same active ingredient, is a win win situation for us and the NHS !

                Jax

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                • #23
                  Re: Medicines Shortage

                  Originally posted by Jax View Post
                  Which, providing the generic product is cheaper, has the same active ingredient, is a win win situation for us and the NHS !

                  Jax
                  In the short term yes, but in the longer term it will result in new drugs not being developed because there is no incentive. That is already a problem in the field of antibiotics.

                  I suspect the big pharma companies will only licence their formulations to the generic manufacturers when R&D costs have been covered and there is little financial incentive to continue manufacture.

                  Even big pharma have limited manufacturing capacity so it makes sense to make high value products rather than the likes of Aspirin and Paracetamol which have very little value nowadays.
                  ---------------

                  Naughty Nigel


                  Difficult is worth doing

                  Comment


                  • #24
                    Re: Medicines Shortage

                    Originally posted by Naughty Nigel View Post
                    In the short term yes, but in the longer term it will result in new drugs not being developed because there is no incentive. That is already a problem in the field of antibiotics.

                    I suspect the big pharma companies will only licence their formulations to the generic manufacturers when R&D costs have been covered and there is little financial incentive to continue manufacture.

                    Even big pharma have limited manufacturing capacity so it makes sense to make high value products rather than the likes of Aspirin and Paracetamol which have very little value nowadays.
                    I was under the impression generic drugs etc could only be produced after the various patents have expired. That should give the drug companies, given the price they charge for new products, ample time to make a profit.


                    Jax

                    Comment


                    • #25
                      Re: Medicines Shortage

                      Originally posted by Jax View Post
                      I was under the impression generic drugs etc could only be produced after the various patents have expired. That should give the drug companies, given the price they charge for new products, ample time to make a profit.


                      Jax

                      Its not quite as simple as that. When a research company discovers a substance that might one day be a useful drug they patent it ASAP. If they don't then another compaany might find the same thing and patent it meaning the first company would no longer be able to continue. There is sometimes a concern that one of their own employees might sell information.



                      Drug patents last 20 years ( or at least they did when I was working in drug research - may have changed). A new drug can take anything from 10 to 15 years to develop to the point where it can be licensed for use. Then it will take some time for prescribers to decide if an individual patient would benefit from the new drug or not.



                      Once the patent expires any company can start manuacturing and selling it.
                      The worst camera is better than the best photographer. Edward Weston

                      Comment


                      • #26
                        Re: Medicines Shortage

                        Originally posted by Naughty Nigel View Post
                        That is already a problem in the field of antibiotics.
                        Develop a new antibiotic and you are guaranteed that it will be used - but only in limited quantities. In many countries it will be prescription only and restricted to specific cases where it is known that existing antibiotics will not work. So you would need to charge a lot in order to pay off the research debt and fund work for the next antibiotic. If bugs develop resistance quickly ( as sometimes happens) it might become useless.



                        Find a substitute for aspirin and paracetamol and you are on a winner - over the counter sales in just about every shop in the country and more or less every person will buy it - more than once.


                        Problem is that the research would be needed for such a drug would be a huge amount more than that needed for the antibiotic so few companies will risk it.
                        The worst camera is better than the best photographer. Edward Weston

                        Comment


                        • #27
                          Re: Medicines Shortage

                          I remember very many years ago (70s ?) a television programme concerning medications, where the presenter showed a box file and stated that it would contain the amount of data needed for approval in the U.K.. They then pointed to a filing cabinet and said that you would require that amount of data for approval in the U.S..

                          I've never been sure what to make of it - whether we're 'underkill' or the U.S. overkill!

                          Jim

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                          • #28
                            Re: Medicines Shortage

                            Originally posted by Jim Ford View Post
                            I remember very many years ago (70s ?) a television programme concerning medications, where the presenter showed a box file and stated that it would contain the amount of data needed for approval in the U.K.. They then pointed to a filing cabinet and said that you would require that amount of data for approval in the U.S..

                            I've never been sure what to make of it - whether we're 'underkill' or the U.S. overkill!

                            Jim
                            Given the litigious nature of the American public I suspect it was more about covering derriere than ensuring the safety of medicines.

                            No doubt the UK and EU have caught up with the USA by now.
                            ---------------

                            Naughty Nigel


                            Difficult is worth doing

                            Comment


                            • #29
                              Re: Medicines Shortage

                              Originally posted by Naughty Nigel View Post
                              Given the litigious nature of the American public I suspect it was more about covering derriere than ensuring the safety of medicines.

                              No doubt the UK and EU have caught up with the USA by now.
                              The same applies to doctors and specialists now. Having recently been on the NHS/Medical roundabout it is almost impossible to get an honest straight opinion or answer from any of the " Health Care Professionals". Every one seems to have been on the same training courses as our politicians and become experts at avoiding direct answers. Probably all due to the flourishing claim mentality flooding the country. One of the worst things ever done was the change in the law that allowed Solicitors to advertise. It opened the floodgates to litigation and made the UK the same as America overnight. Like America we also now have "Ambulance Chasers" ready to phone and convince you to make a claim.

                              If doctors and specialists are constantly afraid of being sued for their actions or in-actions they can't possibly function as they should and the ones who suffer are the general public.

                              Many years ago I attended a First Aid course run by St Johns Ambulance. One of the things they emphasised, even back then, was the danger of being sued after giving first aid in an emergency. I hate to think what the chances are now of receiving first aid from a member of the general public. If they have any sense they will look the other way.

                              Jax

                              Comment


                              • #30
                                Re: Medicines Shortage

                                Originally posted by Jax View Post
                                The same applies to doctors and specialists now. Having recently been on the NHS/Medical roundabout it is almost impossible to get an honest straight opinion or answer from any of the " Health Care Professionals". Every one seems to have been on the same training courses as our politicians and become experts at avoiding direct answers. Probably all due to the flourishing claim mentality flooding the country. One of the worst things ever done was the change in the law that allowed Solicitors to advertise. It opened the floodgates to litigation and made the UK the same as America overnight. Like America we also now have "Ambulance Chasers" ready to phone and convince you to make a claim.

                                If doctors and specialists are constantly afraid of being sued for their actions or in-actions they can't possibly function as they should and the ones who suffer are the general public.

                                Jax
                                ---------------

                                Naughty Nigel


                                Difficult is worth doing

                                Comment

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