Case reported by a cancer patient who has just been discharged The equivalent product reaches 296 euros, the other "only" 129
16 November 2014 – MODENA GAZZETTA
Equivalent, or generic, if you prefer, can it cost more than the original medicine? Theoretically not, but what some Modenese pharmacies have found says the exact opposite. Reason? This will have to be explained by the Region which deals with the purchase of hospital drugs over a large area (therefore not only for Modena), i.e. those that are supplied only through hospitalization facilities and for which pharmacies simply act as a go-between.
The specific case, in fact, reported by a citizen of Modena, concerns an active ingredient, bicalutamide, which was prescribed to him for oncological therapy at the end of his hospitalization. So the patient, once discharged, went to his trusted pharmacy with the prescription in hand. To the classic question that we hear more and more often, "do you want the original or the equivalent?", the man entrusted himself to the pharmacist who began to notice some inconsistencies in the prices.
Bicalutamide Teva, an equivalent medicine with a dosage of 150mg in a pack of 28 tablets, available in our hospitals and loanable - pharmacies are able to have it in half a day and then deliver it to the customer - costs 296.82 euros. So far nothing strange - the high figure should not deceive because there are medicines which, especially for certain pathologies, reach considerable prices - at least until the moment of comparison.
The original drug, in fact, Casodex, is charged to the health service at a cost of 129.84 euros, less than half of the other. And it doesn't matter that it's not loanable. Another original, the Safedex, rises to 239.57 euros, still a lot but still less than the equivalent available to citizens of Modena who unfortunately 
they need. How is it possible that for the same active ingredient, dosage and number of tablets, generics cost a third more and even more than double in one case? These are the questions that the Region will have to answer.
A generic drug is a copy of a branded drug that has been on the market for years and is no longer covered by a patent. Contains the same active ingredient, in the same amount. It shares its pharmaceutical form, route of administration, dosage. Furthermore, it is a bioequivalent of the reference medicinal product, i.e., as the Italian Medicines Agency writes, with the same dose the blood concentration profiles of the two medicinal products with respect to time «are so similar that it is unlikely that they will produce significant differences in the effects of efficacy and safety".
So how can all this happen? It is to be hoped that there was an error, or that the Region paid him a very different amount and much lower than that shown on the pharmacy accounting screens, even lower than the original drug. It must certainly have been due to a virtuous contract managed in a large area logic (that is, which brings together several hospitals from several provinces) or to a particular promotion that led to the choice of this drug. For clarity, it must be said that the patient in question is exempt from payment, but in any case those medicines are paid for by the community which, if it could save money, would do something else with that money destined for health care given the imminent cuts announced by the buildings of Bologna.
