For years my pharmacy has been dispensing Teva for one of my meds at my request since I trust their products. Yesterday I picked up the refill but made by Solco. Pharmacist said cost went up on Teva and they are required to order based on cost of the generic. Assured me it was just as good.

Pill had virtually zero affect. Checking Solco, it's a Chinese company. Wallboard doesn't exactly match the ingredients in Teva. It was like taking a placebo.

FDA gives generic companies a certain latitude in compounding the meds. Bottom line some are better than others. Some are much better.

Trump often talked about how the supply chain includes pharmaceuticals, many from China, and how important it is to return the manufacture to the U.S. Obviously that's now DOA along with other products.

My oldest daughter was on Focalin for ADHD for a while.
We got Dexmethylphenidate as the generic.

At some point, they changed mfgs, and it had almost opposite effect, so had a note put in her file to only fill with Mfg X (can't recall the name).

Come refill time & I called 27 pharmacies near me on a single day, and all anyone had in stock was Mfg Y (the above that had no/opposite effect).

Decided to stop completely & wean with what we had left at home/school, and actually was an improvement, lucky for us.

I once got a bad infection from a root canal. My dentist told me to get the Penicillin 500 MG VK and not to get a generic if I wanted to stay out of the hospital.

Go to GoodRX and see what the cash price is for the drug you want. And if you are near a Costco, go in and see what they will charge to fill it, and also use the GoodRX.

My doc finally got me using GoodRX a few years ago. For several years before that I just thought it was a gimmick. It's not a gimmick.

BTW you do NOT have to be a Costco member to use their Pharmacy. At the door, tell the employee that you are going to the Pharmacy to get a prescription. They will let you in for that. IF you fail to make it clear that you're going to the Pharmacy they will deny you entry.

Sometimes it's better and cheaper to just pay cash for a script instead of fighting the insurance co.

Best wishes to you.

The FDA says generics must be substantially equivalent. The fillers and coating of the pills are always different. Ritalin and generic methlyphenidate are NOT the same. The timed release in Ritalin is much better. For some people it makes no differnce. PBMs do not care they want the lowest price.

quote:

Originally posted by V-Tail:

quote:

Originally posted by ZSMICHAEL:

PBMs

Pharmacy Benefit Managers

This was a good but disturbing read.

“Katherine Eban’s Bottle of Lies exposes the deceit behind generic-drug manufacturing—and the attendant risks for global health. Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects.”

Bottle of Lies

I found this out when I was used to getting TEVA or Mylan brands from Walgreens for most stuff. They started refilling with crap made in India that was clearly inferior even just in the quality of the pill. Stuff didn't work right and I found reports and discussions on websites saying the same thing.

I changed to CVS who still carries TEVA and had my doctor write "fill TEVA only" on the prescription. There is a 20% tolerance on the active ingredient for generics. That means the dose can swing 40% between min and max tolerance, which is not exactly good. Binders and fillers can be different. But the big thing is that time release is not really covered. So if you get a generic time release, the active ingredient is supposed to be the same +/- 20% in quantity, but the time release mechanism is NOT the same and it only has to approximate the non-generic time release.

Then throw in the inherent dishonesty of Indian and Chinese factories, falsifying records, poor quality control and all that and you have a mess.

BUT, the US generally gets the best of what India and China make because we do have the FDA and they do inspections and CAN ban imports from plants or companies if they have a reason. Places like Africa get the bottom of the barrel out-of-spec crap which may have insufficient active ingredients to have any effect.

There is something to be said for the basic expectation of honesty and fair dealing present in Western and mostly Christian countries. I'm not going to say we don't have corruption or fraud, but there is at least a sense of honor and dignity about doing things right. In India lying and cheating is completely normal and expected. And if you go there, the slow motion disaster you see all around you is proof that their culture generates bad outcomes for anything involving "quality". China is different. People generally follow rules and procedures and are afraid to go out of their way. They are more comfortable doing what they are told, how they are told, then thinking for themselves. But the problem is more the bosses who cut corners to save a little money and probably pocket it.

As a hard and fast rule my former mother in law who works for a major pharma, in their QA told me this when looking at drug sourcing.

Good to go
US
EU/UK/Israeli

questionable
Canada
India

Avoid
China/all others.

My dumbass sister in law bought some prescription medication for her Thyroid , in Mexico .
Yeah , it was a lot cheaper . It put her in the ER .

Friend is a doctor. He said when in med. school, at the beginning of a class, the professor dropped a genuine tablet into a water beaker. He dropped a generic of the drug into another water beaker. At the end of the class, the genuine was melted. The generic was untouched.

As an employee of Teva, the supply chain crisis is hitting us too. I work in the sampling dept under supply chain management and it's been tough getting in certain active ingredients. We have plants in India and China and they make all the instant release products and the US sites make most of the timed-release products.

quote:

Originally posted by P250UA5:
My oldest daughter was on Focalin for ADHD for a while.
We got Dexmethylphenidate as the generic.

At some point, they changed mfgs, and it had almost opposite effect, so had a note put in her file to only fill with Mfg X (can't recall the name).

Come refill time & I called 27 pharmacies near me on a single day, and all anyone had in stock was Mfg Y (the above that had no/opposite effect).

Decided to stop completely & wean with what we had left at home/school, and actually was an improvement, lucky for us.