Generic drugs: The benefits and challenges

Generic drugs can be a controversial topic in the veterinary industry. There are many different sides to the story, all with valid points. So why tackle this tough topic here? Mainly because more and more generic drugs are hitting the market and because cost is becoming increasingly important. In addition, the topic of generics tangentially relates to drugs and medications being sold through Internet pharmacies, mass-market retailers, and pet specialty stores. With all these layers, Firstline wants the goal of this article to be clear: to give you information so you and your practice team can make informed decisions about how to best serve clients and patients.

What's in a name?

The first step in giving you the whole picture is ensuring you understand what brand-name and generic drugs are and why brand-name drugs cost more. Simply put, the pharmaceutical companies that produce brand-name drugs have invested money in research and development to create the drug, get it approved by the Food and Drug Administration (FDA), and launch it in the marketplace. (Note: The Environmental Protection Agency regulates pesticides.)

"A lot of information comes out of drug studies," says Dr. Pete VanVranken, owner of Dickman Road Veterinary Clinic in Battle Creek, Mich. "They're investigating the half-life and the lethal dose. So we not only get the drug, we get the information that comes with it."

Generics, on the other hand, are less-expensive alternatives to brand-name products. They're a bioequivalent substitute often manufactured by another company after the original producer's patent expires. The FDA approves generic drugs the same way as brand-name drugs, except rather than an efficacy study for brand-name drugs, researchers conduct a bioequivalence study that shows that the generic drug works the same way as the brand-name, pioneer drug.

Talk as a team

Many practices prescribe both brand-name and generic medications, and understanding how your veterinarian chooses and evaluates medications prepares you for conversations with clients. Dr. Douglas Wyler, director of Animal Medical Hospital and Whitestone Veterinary Care in the New York area, says his practices use staff meetings to educate the team on drug choices as well as new offerings. "We'll discuss new drugs when we bring them on board," he says. "We talk about what they do, why we chose them, and the benefits our patients will derive from them."

Why is this so important? "While doctors make the choice about the products the practice recommends, the entire veterinary team must have confidence in the products they're recommending," Dr. Wyler says. "I've seen generics that failed to give the same response as the brand-name products, and, consequently, we went back to recommending the brand-name products. We've also had generics that completely met our expectations."

He adds that team members also learn a lot about medications from caring for their own pets. Personal experiences help them explain medications, Dr. Wyler says, especially if they've used both the generic and brand-name versions and can outline the benefits and challenges with each.

Click here for tips on talking to your clients about preventives.

What clients need to know

In most cases, your clients probably won't broach the topic of generic drugs. And, like other medical topics, you'll know much more about medications and how they work than you'll ever need to share with pet owners. But your knowledge will help you guide their decisions, especially when clients say they can't afford a medication their pet needs.

"It's a necessity for clients to be active partners in their pets' care," says Kyle Palmer, CVT, a Firstline Editorial Advisory Board member and practice manager at Silver Creek Animal Clinic PC in Silverton, Ore. "It's our philosophy that the client is the presiding responsible party for the pet and should be part of that discussion."

Does that mean clients should be able to decide whether they prefer a brand-name or generic drug? It depends on whom you ask. Some of the veterinarians Firstline spoke to for this story say they start by recommending the drug they think is best for the patient and client, which may or may not be based on whether it's a brand-name or generic drug. If the client declines this initial recommendation and a lower-cost option is available, the veterinarians say they'll offer that option as an alternative. Others say they more actively involve the client in the decision, explaining brand-name and generic options, including their benefits and drawbacks, and offering clients the choice.

Dr. VanVranken makes choices about drug recommendations based partly on cost and ease of administration. (Some generic drugs may not be as pet-friendly as their brand-name counterparts. For example, the generics might be available in larger pills or they may require more frequent dosing.) If Dr. VanVranken involves the client in the decision, he might explain that there's a drug that's more convenient that you give just once a day or one that's less expensive. One caveat: Too much information can be confusing for clients. So it's important that you and your team members know how to focus the message to make the best and strongest impact during every discussion.

The overall point here is that you and your fellow team members need to stay focused on your veterinary practice's ultimate goal: to help clients protect and preserve their pets' health. Remember that the veterinarians are working for the same goal when they select the medications your practice recommends. "I choose what I'd want done for myself," Dr. VanVranken says. "I really do what I think is right for the client."

Portia Stewart is a freelance writer and former Firstline editor living in Lenexa, Kan.