I know this isn’t true of all drugs, especially certain psychiatric drugs & antiepileptics. However, this study finding is a relief.
I did suspect as much since I started taking the generic form of Rapamune, once the generic was made available. I had less concern because I knew Pfizer had it’s own generic imprint, Greenstone, so I knew the medication was identical & equivalent.
The study, conducted by Cleveland Clinic, was done with 70 patients to compare generic tacrolimus to the brand name drug, Prograf. Prograf is manufactured by Astellas Pharma. However, generic tacrolimus is typically manufactured by Sandoz, which is a division of Novartis. So it’s the not the same company that manufactures both drugs (as is the case with sirolimus/rapamune).
This was only one of many concerns patients had when being made to switch, either by insurance or for other reasons. This debate had been taking place on & off since 2009, when the generic version first became available.
The concern obviously with switching was whether the same dose in the generic could maintain the same therapeutic level as the original branded medication.
This sometimes doesn’t always work & with anti-rejection medicines, a decrease in concentration could set off rejection. However, it appeared this was not the case & that they are bio-equivalent.
It looks like similar studies are underway now to test whether the generic, Mycophenolate Mofetil, manufactured by Teva Pharmaceuticals is bio-equivalent to the brand name drug Cellcept made by Genentech.
It looks like switches have taken place with this drug as well at around the same time as tacrolimus, but there was little reported in bio-equivalency study data to date (at least from what I could obtain in a public search).
Ultimately, if transplant patients can safely make the leap, the cost savings is significant.
Prograf is over $150 usually on average, whereas tacrolimus is sometimes less than $50 but no more than $100 on average.
The difference in Cellcept & Mycophenolate Mofetil, is not as significant (probably since there is still co-pay assistance offered by Genentech on the brand medicine).
Over time, the costs add up. Considering the multiple drug regimen most transplant patients are on for the rest of their life, every bit of savings helps. So if the switch to a generic can be tolerated with either one or both drugs, it might be easier on both an insurance carrier’s & the patient’s wallets in the end run.
(Further reading on the concerns raised by this issue can be found on the UNOS website. The section on medications under the Transplant Living section is quite informative & extensive.)
AS I LIVE & BREATHE 
I am and have been on all generic drugs for a long time. From transplant, I’ve been on the generic for of Neoral (cyclosporine) which is Gengraf. I was on brand name Cellcept (Mycophenolate) until the generic version came out and I was immediately put on that, but my transplant team had me go for blood tests every two weeks for 3 or 4 months until I was deemed “stable” …….. then many months later, my pharmacy changed generic manufactures and I went through another round of labs, until I was deemed stable. A year later, the pharmacy changed to yet another manufacture, I called my team and they said, no problem, no more blood tests. I’m also on generic Bactrim, Zocor and get my OsCal from Walmart. It saves lots of cash and is dictated by insurance.
Generics don’t scare me …..
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that’s great to hear. I actually prefer them where possible. I do admit though I’d rather start out on a generic than make the switch where possible to start with tho, just to head off any potential concerns. But I know that’s not always possible.
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