Abstract
In Reply.— Drs Haymes and Levy have made a distinction between pharmaceutical alternates and pharmaceutical equivalents. In our report, Creon and Pancrease (McNeil Pharmaceutical, Spring House, Pa) would be examples of pharmaceutical alternates since Creon was designed specifically to contain twice the lipase content of Pancrease. In contrast, the generic formulation manufactured by Anabolic Inc and Pancrease would be examples of pharmaceutical equivalents since Anabolic manufacturedthe product with the intention of it being substituted for the McNeil formulation. Moreover, Rugby Laboratories (Rockville Center, NY), a distributor of generic drug products, advertised the Anabolic product as a generic equivalent to Pancrease in their 1989-1990 catalog, and pharmacists dispensed it as a generic equivalent. Once the generic product sold by Anabolic Inc was removed from the market-place, Rugby and Goldline, each distributors of generic products, replaced it with a formulation manufactured by Pharmaceutical Delivery Systems Inc (Creve Coeur, Mo). Technically,
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