Modena. Drugs, a generic that costs more than the original

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.

Il bicalutamide Teva, medicinale equivalente dal dosaggio di 150mg in confezione da 28 compresse, disponibile nei nostri ospedali e mutuabile – le farmacie sono in grado di averlo in mezza giornata per poi consegnarlo al cliente – risulta costare 296,82 euro. Fin qui nulla di strano – non deve ingannare la cifra elevata perché ci sono medicine che, soprattutto per determinate patologie, raggiungono prezzi ragguardevoli – almeno fino al momento del confronto.

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.

Un farmaco generico è la copia di un farmaco di marca presente sul mercato da anni e non più coperto da brevetto. Contiene lo stesso principio attivo, nella stessa quantità. Ne condivide forma farmaceutica, via di somministrazione, dosaggio. Inoltre è un bioequivalente del medicinale di riferimento, vale a dire, come scrive l’Agenzia italiana del farmaco, con la stessa dose i profili di concentrazione nel sangue dei due medicinali rispetto al tempo «sono così simili che è improbabile che possano produrre differenze rilevanti negli effetti di efficacia e sicurezza».

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.