Branded Medicines Research Articles

“Own Name,” “No Name,” and “The Plague of Fancy Names”

Within popular narratives of the nineteenth century, branded commercial remedies—with their hyperbolic advertisements—are often cast in an unsavory light. This article reconsiders branded medicines and draws on scholarship from business historians to show that brands in the British marketplace were redefined during the late nineteenth century as a result of trademark legislation, particularly the Trade Marks Registration Act 1875. Concentrating on advertisements and commentary from the trade and professional press between c. 1875 and c. 1920, this article explores how trademarks were used as a regulatory and communicative device within a chain of distribution. Pharmacists, however, were wary of the “plague of fancy names,” as <i>The Pharmaceutical Journal</i> wrote on May 12, 1906, and many retail chemists did not want their own name usurped by a manufacturer’s brand within their own retail space. Mindful of this concern, manufacturers and wholesalers began to offer a range of “No Name” or “Own Name” preparations. This article will highlight that some brands could hold great value in certain local areas, but it also draws on the archives of Burroughs Wellcome &amp; Co. to outline trademark legislation’s impact on the sale and understanding of commercial remedies on a global scale.

A Comparative In-vitro Dissolution Profiles of Generic and Branded Amoxicillin

There are two types of Amoxicillin in the form of tablets, generic and branded medicines. Generally, drug products undergo systemic absorption through a series of processes, including disintegration of drug products followed by drug release, dissolution of drugs in aqueous media, and absorption through cell membranes into the systemic circulation. Dissolution profiles of generic and branded Amoxicillin were used to reference the public to choose generic Amoxicillin or branded Amoxicillin. It was because branded Amoxicillin is more expensive than generic Amoxicillin. This study aims to determine the dissolution profile and physical properties of both generic and branded amoxicillin tablets produced by the same pharmaceutical manufacturer. The Measurement of physical properties was carried out with several parameters: uniformity in weight and size, fragility test (friability), and disintegration test. All the results can meet the acceptance requirements that refer Indonesian Pharmacopoeia 5th edition in 2013. The physical properties result obtained by each. The dissolution test was done using an ultraviolet spectrophotometric method; dissolution tools were typed two apparatuses at 75 rpm with aquadest for 30 minutes, 37 ± 0,5 oC. The dissolution profile of generic Amoxicillin was declared identical or similar to branded Amoxicillin. It can be seen from F1 value = 3.40 and F2 value = 67.77, each of which meets the identical category's standard. Dissolution profiles of generic and branded Amoxicillin were declared identical, which means the Amoxicillin's quality control was equally excellent.

Attitude towards generic drugs: A comparative study among clinicians and pharmacy professionals

Introduction: Generic medicines play a prominent role in pharmaco-economics by providing medicines at a much less price. Generic formulations usage is increasing as they provide the same therapeutic effect as branded medicines at a much more economical price. Attitude towards the usage of generic medicines plays a key role in the usage of these medicines by the pharmacist and clinicians. As limited data is available in this area the current study focuses on attitude towards the generic medicine usage of physicians and pharmacists. Materials and Methods: The current study was conducted at KMC&H and Hindu college of pharmacy. After prior ethical clearance, attitude towards the generic formulations was measured using ATGM scale and questionnaire among the physicians, pharmacy professionals and general population. Statistical analysis was done using EPIINFO software. Results and Conclusion: Both Groups believe that Generic medicines do not produce more side-effects than brand name medicines. Pharmacy group has more positive attitude towards most of the items in this questionnaire. In conclusion, more Positive attitude is observed in the pharmacy group than the medical group. This indicates there is a need to increase the awareness among the medical professionals regarding generic formulations. Keywords: Generics, Attitude, Pharmacy.

Improving access to the treatment of hepatitis C in low- and middle-income countries: evaluation of a patient assistance programme

Background Modern antiviral treatments have high cure rates against the hepatitis C virus however, the high cost associated with branded medicines and diagnostic tests, have resulted in poor access for many low-income patients residing in low-and-middle-income countries. Objective This study aimed to evaluate the role of a patient assistance programme and generic medicines in improving access to treatment of low-income hepatitis C patients in a low-and-middle-income country. Setting A major teaching public hospital in Islamabad, Pakistan. Methods Hepatitis C patients who presented and enrolled for the patient assistance programme during 12 months (1st July 2015 and 30th June 2016) were included. Demography, prescription characteristics, the total costs of Hepatitis C treatment, medicine cost supported by the programme, out-of-pocket cost borne by the patient and average cost effectiveness ratio per sustained virologic response were calculated and compared for different generic and branded regimens. Main outcome measure cost contribution of patient assistance programme. Results A total of 349 patients initiated the treatment through the programme and of those 334 (95.7%) completed the prescribed treatment. There were 294 (88.02%) patients who achieved sustained virologic response. Patient assistance programme contributed medicines cost averaging 60.28–86.26% of the total cost of treatment ($1634.6) per patient. The mean (SE) cost per patient for generic option (Sofosbuvir/Ribavirin) was the lowest [$658.36 (22.3) per patient, average cost effectiveness ratio = $720.1/SVR] than branded option (Sovaldi/Ribavirin) [$2218.66 (37.6) per patient, average cost effectiveness ratio = $2361.8/SVR] of the three available treatment regimens. From patients’ perspectives, the mean (SE) out-of-pocket cost was $296.9 (6.7) which primarily included diagnostic cost (69.9%) of the total cost. Conclusions Patient assistance programme, combined with generic brands of newer hepatitis C treatment offered a significant reduction in cost and widens access to hepatitis C treatment in low-and middle-income countries. However, substantial out-of-pocket costs of the treatment presents an important barrier for service access. There is a scope to widen such financial assistance programme to offer other costs attributed to patients, specifically for diagnosis, to widen service use in low-and-middle-income countries.

A study of patient awareness regarding the purchase of generic and ethical branded medicines

A study of patient awareness regarding the purchase of generic and ethical branded medicines

Authentication of Antibiotics Using Portable Near-Infrared Spectroscopy and Multivariate Data Analysis.

Counterfeit medicines represent a global public health threat warranting the development of accurate, rapid, and nondestructive methods for their identification. Portable near-infrared (NIR) spectroscopy offers this advantage. This work sheds light on the potential of combining NIR spectroscopy with principal component analysis (PCA) and soft independent modelling of class analogy (SIMCA) for authenticating branded and generic antibiotics. A total of 23 antibiotics were measured “nondestructively” using a portable NIR spectrometer. The antibiotics corresponded to six different active pharmaceutical ingredients being: amoxicillin trihydrate and clavulanic acid, azithromycin dihydrate, ciprofloxacin hydrochloride, doxycycline hydrochloride, and ofloxacin. NIR spectra were exported into Matlab R2018b where data analysis was applied. The results showed that the NIR spectra of the medicines showed characteristic features that corresponded to the main excipient(s). When combined with PCA, NIR spectroscopy could distinguish between branded and generic medicines and could classify medicines according to their manufacturing sources. The PCA scores showed the distinct clusters corresponding to each group of antibiotics, whereas the loadings indicated which spectral features were significant. SIMCA provided more accurate classification over PCA for all antibiotics except ciprofloxacin which products shared many overlapping excipients. In summary, the findings of the study demonstrated the feasibility of portable NIR as an initial method for screening antibiotics.

PNS55 The Effect of Pharmaceutical Policy on Demand for Branded Medicines: A Discrete Choice Experiment from Australia

In Australia prescription medicines on the Pharmaceutical Benefits Schedule are subsidised. Patients can access these medicines by paying a co-payment, with the government paying the difference between the listed price and the co-payment. The listed price to government for the medicines is often much higher, and can vary across different brands of the same medicine. We evaluated consumer preferences for medicines under a hypothetical policy in which there is a choice between the subsidised medicine (for $40) or a full priced (range $35 - $120). We designed a discrete choice experiment (DCE) in which consumers were asked to choose their preferred medicine (original brand or generic) for a hypothetical health condition. The attributes of the medicines included the cost to the consumer, whether it is listed for government subsidy, collection time (dispensed now or later in the day) and whether or not the pharmacist recommended the product. Respondents (N=1,248) were recruited via an on-line panel. Analysis was undertaken using mixed logit willingness to pay and latent class (LCA) models. Consumers prefer the subsidised medicine. On average, they are willing to pay $3 more per script for the pharmacists recommendation, $2 for a drug that is reimbursed by the government, but only $1 more for an original brand medicine. The LCA revealed four distinct classes of individuals: a class that prefers the branded product irrespective of any other attributes; a class that strongly attends to the pharmacist’s recommendation; and two classes that both prefer lower prices and subsidised products, one of these classes also have a preference for collection time and pharmacist recommendation. The majority of respondents prefer the subsidised medicine, irrespective of brand, with only a small proportion of respondents choosing the more expensive branded medicine. Suggesting that pricing policies that allow brand premiums may have limited impact on consumer choices.

Customers’ response to the offer of substitute brands of medicines for the prescribed ones – An exploratory study of consumer behavior in North India

Patients/customers are offered a substitute brand of medicine generally when the prescribed brand is not available at retail store. However, the customers respond in various ways to such an offer. There are many factors that affect the acceptance/rejection of the substitute brand by the customers. This study’s objective is to categorize consumers’ responses to the offer for substitute brand of medicine in place of the prescribed one in north India. Another objective of the study is to identify common characteristics of customers falling in different response categories. Researchers conducted in-depth interviews with chemists/retailers and customers. The common responses of the customers to the offer of substitute drugs were- straightway acceptance, acceptance of substitute brand after the assurance of substitute being chemically equivalent by the pharmacist and rejection of the substitute. Education, age, trust on pharmacist and perceived seriousness of illness were the main factors affecting the acceptance of substitution.

GENERIC DRUG: PRESCRIBER’S PERSPECTIVE

Objective: Knowledge of doctors and their understanding of generic drugs could facilitate in recognizing potential barriers to larger generic medicine prescriptions. Hence, the primary objective of this study was focused to explore knowledge, attitude, and practice (KAP) of doctors toward generic medicines.&#x0D; Methods: It is a cross-sectional questionnaire-based study. The study participants are the doctors working in the hospital during the study period (2016–2017). The questionnaire designed for this study comprised of thirty-five questions related to the knowledge, attitude, and practice (KAP) of generic medicine and about demographic details of the participants.&#x0D; Results: A total of 86 questionnaires were distributed among the health care professionals and the response rate is 37%. The majority of doctors who participated in this survey perceived that generic medicine is effective, safe and need to have the same active component, dose and bioequivalent as the brand name medicines. Most of the doctors (72%) were of the view that generic drugs were manufactured in poor quality than branded medicines. More than three-quarters of doctors (78%) prescribed generic drugs.&#x0D; Conclusion: Majority of the participants had an honest angle about the efficaciousness and safety of generic and though they sometimes prescribe generic medicine, however a high range of doctors (72%) were of the opinion that generic was of poorer quality than brand medicine. To have a better understanding of the generic drug, the doctor must be well informed about the generics during their academic career resulting in savings to healthcare budgets.

Effects of anxiety on preferences for generic medicines in Australia.

Generic medicines have been available to consumers for ∼40 years, with varying degrees of uptake in different countries. Despite offering equivalent therapeutic qualities, generic medicines still struggle to be accepted by consumers. This study examines the role of a consumer's affective state and framing effects on the purchase of a branded versus a generic pharmaceutical product. These issues are examined in an experiment, with independent manipulations of consumer anxiety levels and the framing of generic alternatives by the pharmacist. The sample comprised 426 men and women within Australia who completed an online survey with a scenario of purchasing a pharmaceutical after visiting a General Practitioner. Results indicate that those consumers experiencing higher levels of anxiety and where the doctor prescribed the branded medicine are more likely to choose branded medicines over cheaper, generic alternatives. The effect of framing the generic alternative as either 'generic' or 'cheaper' was not significant.

Hepatitis C Virus Treatment in Children: A Challenge for Hepatitis C Virus Elimination.

Hepatitis C is a global public health threat. The introduction of direct-acting antivirals (DAAs) brings the prospect of curing the 71 million people living with the disease, dramatically changing the landscape of hepatitis C. The World Health Organization developed a roadmap for the elimination and cure of hepatitis C by 2030 with a clear goal with measurable targets. However, there is a lack of a well-defined strategy to tackle the hepatitis C virus (HCV) problem in children and adolescents vis-à-vis the adult population. Hepatitis C in children and adolescents can be addressed as part of a national policy for elimination in the whole population, namely macroelimination, or could be fragmented into a microelimination approach targeting the high-risk population groups. Children born to HCV-infected mothers, adolescents who are injecting drugs, migrants, and those suffering from inherited blood diseases are important target populations. After the U.S. Food and Drug Administration approval for the use of DAAs in children aged 3 years and above, evidence from clinical trials and real-world experience was accumulated using brand and generic medicines, with sustained virological response rates exceeding 95%. The evidence created should guide policies on the management of hepatitis C in children and adolescents. There are many challenges in managing HCV in this left-behind marginalized population. The lack of awareness and epidemiological data, consent age, prohibitive prices of medicines, and absence of policies on access to diagnostics, treatment, and linkage to care are among the many barriers to service delivery that should be addressed to achieve the elimination goal by 2030.

Generic medicine brand knowledge structure, relationships and purchase

Purpose Cheaper generic anti-retroviral medicines are encouraged and often prescribed in South Africa for HIV/AIDS treatment. However, the medicines’ acceptance rate is relatively low. This has been attributed to inadequate brand knowledge of the bioequivalence of generic medicines. Studies have examined how brand knowledge structure lead to purchase. The contributions of brand relationship builders (i.e. trust and satisfaction), which are indicators of sustainable purchase, are rarely considered. This study aims to adapt Esch, Langner, Schmitt and Geus’ (2006) brand knowledge structure and relationship model to examine the impact of South African young adults’ brand knowledge structure (brand awareness, brand image and brand beliefs) and trust on brand satisfaction and purchase. Design/methodology/approach Cross-sectional data was quantitatively collected from 207 young adults through self-administered, paper-based questionnaires. Data was analysed with structural equation modelling. Findings Brand awareness, image, trust and belief in efficacy positively influenced purchase. All these factors, except brand awareness, positively led to satisfaction. The tested adapted model explained 53.0 and 58.5% variances of purchase and brand satisfaction, respectively. Practical implications Considering how much brand knowledge structure and trust explained purchase and satisfaction from the tested model, South African government, pharmaceutical marketers and consumer interest groups should educate young adults about the bioequivalence, safety and efficacy of generic medicines. With greater knowledge of these qualities, satisfaction is gained from purchase decision. Originality/value Instead of the usual examination of demographic differences in generic medicine beliefs and perception, this study contributes by revealing brand-related drivers of purchase and satisfaction.

A comparative analysis of medicine prices in Latin America

This paper compares medicine prices in the six largest economies in Latin America. Using a panel-based econometric model with country fixed effects and controlling for variables related to the medicines’ characteristics, the comparison covers 19,741 units sold during the 2010–2015 period and has been carried out at the wholesale and retail levels and by type of medication (innovative, branded generic and generic). At the aggregate level and at the retail pharmacy level, the classification from least to most expensive is: Peru, Mexico, Argentina, Chile, Colombia and Brazil. In innovative medicines, Argentina and Peru have the lowest prices. In branded generic medicines, Mexico and Argentina have the lowest prices, while for pure generics, Peru and Chile appear to be the least expensive. The classification does not change substantially if ex-factory prices are compared.

Poverty and Access to Medicine: A Medico Legal Study

The right to health as a basic human right- and access to medicine as a part of it- have been a matterof attention for several decades. Also the responsibilities of different parties- particularly pharmaceuticalcompanies- in realization of this right have been emphasized by World Health Organization. This is whilemany companies find no incentive for research and development of medicines related to rare diseases. Alsosome legal structures such as “patent agreements” clearly cause huge difficulties for access to medicinein many countries. High prices of brand medicine and no legal production of generics can increase thecatastrophic costs- as well as morbidity-mortality of medication in lower income countries. Here weevidently review the current challenges in access to medicine and critically assess its legal roots. Howsocieties/governors can make the pharmaceutical companies responsible is also discussed to have a look onpossible future and actions that policy makers- in local or global level- can take.

Pharmaceutical pricing policy in Saudi Arabia: findings and implications

Introduction: Many countries have introduced policies and strategies to limit pharmaceutical expenditures. These include pharmaceutical pricing policies and related strategies to control medicine prices and to ensure appropriate and stable prices. The aim of this study was to provide an overview of the current pharmaceutical pricing policy for medicines in Saudi Arabia and to provide an evaluation of the impact of this policy on medicine prices. Methods: A description of the current pharmaceutical policy is presented by reviewing the current official documents and regulations related to pharmaceutical pricing in Saudi Arabia. A price comparison between the original brand medicines and their generic versions was conducted for the top six selling medicines in Saudi Arabia during the period of 2010–2015. Results: The findings showed that Saudi pharmaceutical pricing policy takes into consideration several factors including an international price benchmark, internal price referencing, and the price of the medicine in the country of origin when determining medicine prices. Based on this policy, there were large differences in the prices of generic medicines compared to original brand medicines. The generic medicine to original brand medicine price ratio was 0.87–0.30. However, the price of the first generic medicine was close to the price of original brand medicine, with the first generic medicine-to-original brand medicine price ratio was 0.87–0.81. In this study, there were large differences in the prices of generic medicines for the same molecule. In fact, price ratio among the generic medicines for the same molecule was between 0.96 and 0.18. However, some generic medicines imported from high income countries were cheaper than the medicines manufactured locally or manufactured in other countries in the Middle East. Conclusion: Medicine prices are strictly controlled through the pharmaceutical pricing policy in Saudi Arabia. Overall, the current policy has resulted in significant price differences among medicines, including medicines of the same molecule. Due to this large difference, the cost savings will depend on the product prescribed or procured by the health organization.

The 'Netflix plus model': can subscription financing improve access to medicines in low- and middle-income countries?

At present, pay for prescription models are insufficient at containing costs and improving access to medicines. Subscription financing through tenders, licensing fees and unrestricted or fixed volumes can benefit stakeholders across the supply chain. Pharmaceutical manufacturers can reduce the need for marketing expenses and gain certainty in revenue. This will decrease costs, improve predictability in budget expenditure for payers and remove price as a barrier of access from patients. Inherently, low- and middle-income countries lack the purchasing power to leverage price discounts through typical price arrangements. These markets can realise substantial savings for branded and generic medicines through subscription financing. Procuring of on-patent and off-patent drugs requires separate analysis for competition effects, the length of contract and encouraging innovation in the medicine pipeline. Prices of competitive on-patent medicines and orphan drugs can be reduced through increased competition and volume. Furthermore, pooling expertise and resources through joint procurement has the potential for greater savings. Incentivising research and development within the pharmaceutical industry is essential for sustaining a competitive market, preventing monopolies and improving access to expensive treatments. However, technical capacity, forecasting demand and the quality of generic medicines present limitations which necessitate government support and international partnerships. Ultimately, improving access requires progressive financing mechanisms with patients and cost containment in mind.

CONSUMER PERCEPTION AND BRAND LOYALTY TOWARDS OVER THE COUNTER BRAND MEDICINES OF MAJOR PHARMACEUTICALS COMPANIES WITH SPECIAL REFERENCE TO RAJASTHAN

The study intends to explore the consumer perception towards over-the-counter (OTC) medicines and factors that influence consumer buying behavior for OTC brand medicines marketed by pharmaceutical companies. It also aims to study the impact of marketing mix factors on consumer perception and OTC brand loyalty. The research is descriptive in nature. It is based on primary data which is collected via structured questionnaire. The hundred respondents were participated in pilot study to understand and validate the questionnaire. The primary data obtained are analysed to identify the consumer perception and OTC brand loyalty promoted by the pharmaceutical companies. The study was conducted in period of 1 December 2016 to 31 March 2017. The respondents are from different districts of Rajasthan. 411 respondents participated on simple convenient non-probability sampling basis. In the study the dependent variables like consumer perception and brand loyalty with independent variables like consumer self-medication and OTC marketing mix factors are considered. It is observed in present study that OTC marketing mix factors like Place, Price and Promotion has positive impact on consumer perception and OTC brand loyalty whereas self-medication practices have negative impact. The study also revealed that Place (Product availability), Price and Promotions are the major influencing factor in considering consumer OTC medicine buying behavior.

Fifth stage pharmacy students’ knowledge and perceptions about generic medicines

The aim of the current study was to evaluate the knowledge and perception of the fifth stage pharmacy students (college of pharmacy/ University of Baghdad /Iraq) regarding generic medicines. This study is a cross-sectional study carried in a college of pharmacy /University of Baghdad during the period from (November 2018- March 2019). The number of students included in the current study was 168 undergraduate stager pharmacists. A questionnaire was used to collect data of the study. Nearly 86% of the students said that they had heard of generic and brand medicines, and pharmacy was the main source of knowledge regarding generic medicines (66.7%). About (33.3%) of the respondents agreed that generic medicines are bioequivalent to brand medicine. However, (38.1%) perceived generic medicines might not be the therapeutic equivalent of brand medicines. In addition, (35.1%) of the respondents believed that generics are lower in quality, which is why they are cheap and produce more side effects. Moreover, (41.1%) of the sample agreed that generic medicines should be avoided in life-threating situations. About (56.5 %) of the students were found to have a poor level of perception regarding the use of generic medicines. The majority of the fifth stage pharmacy students (college of pharmacy/ University of Baghdad /Iraq) were found to have a good knowledge but a poor level of perception about the use of generic medicines.

ORAL ANTIDIABETICS AGENTS AVAILABLE IN INDIAN PHARMACEUTICAL MARKET: A PRICE VARIATION ANALYSIS

Objective: There are hundreds of brands in Indian markets for a single drug which is manufactured by various companies and thus leads to wide variation in prices for the same drug. Hence, we decide to evaluate the variation in price of different brands of the same drug available in Indian market.&#x0D; Methods: An analysis was done for comparing price variations among various drugs prescribed in diabetes mellitus. Indian Drug Review (IDR) (2019 Volume XXV Issue 4) and Current Index of Medical Specialties (CIMS) (July 2019–October 2019) were referred to know the maximum and minimum price in INR of drugs in all available strength and dosage forms being manufactured by different companies in India and percentage price variation was calculated.&#x0D; Results: Wide variation in the price of several brands of oral antidiabetics is found in Indian market. In single drug, highest price variation is found for glimepiride 1 mg tablet (1365.5%). In fixed-dose combinations (FDCs), highest price variation is found for glimepiride + metformin (2 mg + 500 mg) sustain release tablet (689.2%). Lowest price variation for FDCs was found for glimepiride + metformin (3 mg + 500 mg) tablet (4.8%). Furthermore, only few oral antidiabetic agents were included in the drug pricing control order 2013. Wide variation is seen in prices of brand and generic medicines.&#x0D; Conclusion: All the stakeholders should collectively make efforts to reduce price variation among the various brands so as to make them affordable and aim to improve the health status of the community.

Perception toward low-cost generic medicines and their usage among dental patients visiting community outreach programs in the peripheral areas of Bangalore South: An exploratory cross-sectional survey

Background: The burden and prevalence of oral diseases are higher in developing countries, especially among the poor and disadvantaged populations. These people may suffer from various dental and systemic illnesses. Hence, provision of reducing the out-of-pocket money by purchasing generic drugs might enable better oral and general health-care-seeking behavior. Objectives: The objective was to assess the perception toward low-cost generic medicines available through the Pradhana Manthri Bhartiya Janaushadhi Pariyojana and their usage among dental patients visiting community dental outreach programs conducted in the villages near a tertiary care dental teaching hospital, Bangalore South. Materials and Methods: An exploratory descriptive cross-sectional survey was carried out over a period of 3 months among 200 residents participating in the dental outreach programs in 15 villages of Bangalore South. Data were collected using a prevalidated closed-ended interviewer-administered questionnaire. Results: Most respondents (82.5%) were not aware of Prime Minister Jan Aushadhi Kendra (PMJAK) and only 17.5% knew about the nearest PMJAK. The majority (96.5%) were not aware of the availability of dental-related medicines in PMJAK and (95.5%) preferred to buy Jan Aushadhi drugs over branded medicine if the quality of generic and branded medicine is the same. Most respondents (98%) liked to have more awareness through mass media about PMJAKs/medicines. Conclusion: The results indicate that more awareness must be created, and strict laws implemented about the Jan Aushadhi scheme to save health cost expenditure; if the quality of generic and branded medicine is the same, most people are willing to use the medicines sold at PMJA Kendras.