Patrick J. Skerrett

A conversation with Dr. Jerry Avorn about drugs and the drug industry

Americans spend more than $300 billion a year on prescription drugs. How we use these drugs, and how effective they are, have become important subjects for public health researchers. A leader in this area is Dr. Jerry Avorn, chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital in Boston and professor of medicine at Harvard Medical School. Avorn is the author of numerous articles and the book Powerful Medicines.

Dr. Jerry Avorn

For an article in the Harvard Health Letter, editor Peter Wehrwein spoke with Avorn about generic drugs, the pharmaceutical industry, the high cost of cancer drugs, and more. Here’s an excerpt from their conversation; you can read the complete interview at www.health.harvard.edu.

PW: We get a lot of questions from readers about generic drugs and whether they really are just as good as brand-name drugs. Are they?

JA: Yes they are. Generics are often made by the same companies that make the branded products. And if they aren’t, they are usually made by equally large companies that the FDA subjects to the same degree of quality control as brand-name manufacturers. We are collectively wasting billions of dollars on brand-name drugs when we can buy generics that are just as safe and effective, for as little as $4 a month.

PW: We also get questions about the side effects of statins. Do you think they have been downplayed?

JA: Statins have prevented enormous amounts of sickness and death from heart disease; they are fantastic drugs. But it’s also probably fair to say that we are not as good as we should be about studying side effects that don’t land people in the hospital—or kill them. I think we have a good handle on statins and rhabdomyolysis, the muscle breakdown that can be fatal. But I don’t think we have studied as carefully as we should have the extent to which statins sometimes make people ache. And making tens of millions of people ache — that’s not nothing.

PW: Are you optimistic or pessimistic about the future of medications and their regulation?

JA: I am optimistic. The examples of what happened with Vioxx and several other problematic drugs have had a bracing effect on how we understand and study medications that is analogous to the bracing effect that thalidomide had on drug regulation in the 1960s. The other thing that gives me hope is that we have begun to pay more attention to the way existing drugs are used — and not used. The next big dent in heart disease, diabetes, and hypertension may come not from a new blockbuster drug but from understanding better how we can get people to take their medications and help them afford them.

The Harvard Health Letter is a general interest health and medical newsletter published monthly by Harvard Medical School.

Related Information: Harvard Health Letter

Comments:

  1. arafat

    Drugs are the extreme poisoning which kills human body slowly.As a result asian country they not fully rely on drugs for medicine. Thanks

  2. Alex

    Genetics are allowed to differ in their active Pharm product by a significant %. eg, if brand contains 5mg of a product, generic may contain 4.8mg ,and still allowed to label as 5mg. I stand to be corrected

  3. Philip Gott

    I just saw Dr Avorn on PBS say that all generics are equal to the brand name and believe he is doing a disservice to us with such a broad statement. I know from personal experience that this is not true. I have been taking Toprol XL for high blood pressure for ten years and when given a generic by a new pharmacy, I soon realized that it wasn’t working as well, endangering my life. My understanding is that the binder in the generic is different and unregulated and that the full absorption of the active ingredient was inhibited by the inefficient binder. I switched back to the brand name and my blood pressure returned to healthy levels.
    I salute Dr Avorn’s efforts at counter-detailing but some generics are just not equivalent. I also doubt seriously if drugs manufactured in China get the same scrutiny as those made in the US (if there still are any).

    Philip Gott
    Greenville SC

  4. LCaine

    I beg to disagree with the general statement that generics are as good as brand names. I have trigeminal neuralgia and am on tegretol XR for it. Works great. My pharmacist substituted the generic carbamazapine xr and all the pain came back. My brillian neurologist said that some medication are difficult to make… this being one of them. Maybe the good doctor needs to see which generics work and which don’t. Or is that another book?!?

  5. colleen gilgenbach

    This guy DOES NOT know what he is talking about. I experienced first hand the difference between Welbutrin and a generic brand when my insurance refused to pay for Welbutrin. It took me a while to figure out what was wrong with me and why I was crying and depressed. I went back on Welbutrin at my expense and was fine again.

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  7. Madhu - the Bengali translator

    Although drug remains to be an important aspect to our everyday living but it has its advantages and disadvantages as well. All drugs have its own side effects. Sometimes it can become a real killer of your life. And also in certain part of the world the medicine does not come as it gets branded. People at certain times get the substandard product of it. So it is better to avoid using drugs at abundance.

  8. Stibony

    Genetics are allowed to differ in their active Pharm product by a significant %. eg, if brand contains 5mg of a product, generic may contain 4.8mg ,and still allowed to label as 5mg. I stand to be corrected.

  9. adam

    drug is a slow killer.that’s why in some asian country they not fully rely on drugs for medicine

    mehere

  10. Anonymous

    Statins have prevented enormous amounts of sickness and death from heart disease; they are fantastic drugs. But it’s also probably fair to say that we are not as good as we should be about studying side effects that don’t land people in the hospital—or kill them. I think we have a good handle on statins and rhabdomyolysis, the muscle breakdown that can be fatal.

  11. medicine in india

    hi
    this is gokul from india.
    the drugs plays a vital role in human life.
    ya me too have a question on generic drugs
    how are the differ from non generic ?
    could you pls explain ?

  12. Stibony

    Well said Sir. But in our part of the world (West Africa) generics MAY not be as good as the branded. We get substandard products from India and other places.