--The science demonstrating that generics are, in fact, bioequivalent to the name brands with which they compete has improved greatly. One argument opposing generics has traditionally been that they are not a true substitute, but now it is easier to tell if that is true scientifically, Kirking said.

--Significant restructuring in the pharmaceutical industry has led to cases where the same company makes a brand-name drug and its generic equivalent, or owns a subsidiary that does, while those companies that make only generics are merging and consolidating.

Kirking, who is professor and chair of the Department of Social and Administrative Sciences in U-M's College of Pharmacy and a research scientist in health management and policy at the U-M School of Public Health, said many people in the health care industries looked to generics as a quick-fix way to cut costs. For a number of reasons, that is not realistic, he said.

For example, a number of the most expensive medications are still under patent so no generics exist, and once the end of the patent draws near, clever pharmaceutical manufacturers reformulate---such as providing a 12-hour pill instead of one that works for four hours---and get a patent on the new and improved drug.

Kirking said therapeutic interchange might prove to play a bigger role in balancing the desire to reduce costs with the need to provide effective medication. Therapeutic interchange involves moving a patient from one drug to a different but related drug, as opposed to its chemical twin generic. This can be helpful both because very similar drugs sometimes have very different prices, as well as because one drug might not have a generic equivalent, but a related drug might. That could lead to first moving the patient from one brand-name medication to another, then t
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Contact: Colleen Newvine
cnewvine@umich.edu
734-647-4411
University of Michigan
10-Oct-2001