Generic issues?

[Anonymous]

I’ve been on the same brand of medication for 10 years, Concerta(slow release Ritalin). Recently my pharmacist substituted it with generic and since I’ve been taking the generic it’s been a disaster!!!

My mother who a nurse is like “It’s exactly THE SAME BLAH BLAH BLAH!”

Well here in lies the problem she’s partially right.

Yes it is the same active ingredient, but the time release and amount and strength(at least I’m finding) is not the same as the brand name I’ve been taking for ten years, so now I’m a distracted mess who can’t get ANYTHING done, all my symptoms that used to be at least muted are all over the place with my ADHD. I’m miserable and I’m seeing a difference I wonder if my instructors at school are to. I’m upset and not to happy with the direction my attention has taken.

I know I can always demand “no substitutions” but that doesn’t fix the three month supply of generic concerta I have in my procession or the fact that insurance LOVES the generic…. I have no idea what to do, anyone else in the same boat?

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[Scattybird]

I guess you could tell your pharmacist that the side effects are unacceptable and see what they can do about it. Ask you doctor to specify the name on your next prescription.

I take methylphenidate (fast release) and I asked to try Ritalin this time rather than the alternative brand I was given – just out of curiosity. Both kinds probably do the same thing but the Ritalin is much smoother and I don’t get the side effects that I got with the original drug.

So whilst the active ingredient is as good, the fillers or something is different. With your slow release version I can believe there is likely to be potentially an even greater difference. You should see if you can return the ones you have. I don’t know if that’s allowed but since it’s not of your doing and it’s affecting you it is worth a try.

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[JimC.]

I found this: http://www.addadhdblog.com/generic-concerta-in-canada/?doing_wp_cron#4060a -Worth a read for the whole thing.

*note: this is in Canada; don’t know where you live.

Janssen Ortho Releases A Program To Help To Keep You on Brand Name Concerta:

Janssen Ortho is the company making Concerta. They have invested a lot of resources into developing Concerta, as well as educating doctors, educators, and patients and their families about ADHD and its potential impact on people’s lives.

The acceptance of the generic medicine as ‘interchangeable’ is leading to people being taken off of Concerta and being put on the generic very quickly.

Janssen has created a program which can help you to stay on the brand name product. It is called the: “Concerta Co-Pay Assist Program”.

What happens is this:

You get a prescription from your doctor that says: Concerta No Substitution

You go to the pharmacy, and give in the prescription – and insist that you get the brand name product.

If the pharmacy says that your insurance will only cover the generic product, and you have to pay the difference – then you give the pharmacy a ‘Concerta Co-Pay Assist Card, and then Janssen Ortho will pay the difference between the generic medicine and the brand name medicine.

In other words, when you give one of these cards to the pharmacist – you won’t have to pay any extra above the costs of the generic medicine. This applies whether you are on the Ontario Drug Benefit Card, or whether you are on private insurance (i.e. from your work), or even if you are a cash payer.

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[Anonymous]

I am Canadian, and I’m also out of province at school right now and I filled my Prescription in Nova Scotia and now I’m back in New Brunswick, I suppose I could call the pharmacy to see anything can even be done, but like I said I have three months worth of generic right now and my focus is crap, the release is SIMPLY not the same and agrueing with my mother is like arguing with a wall….Thanks for that link I’m going to see if I can get a hold of one of these said cards….still it’s frustrating I think it should be illegal to make generic substitutions without informing the patient and consulting a doctor, I’ve been on the same BRAND name concerta FOR ten years any change and no crap I’m going to notice and see a difference I’m just so angry with the situation because I WAS doing so well in school!

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[JimC.]

@fortheloveofcats: call your doc and ask what to do. S/he may know of the Concerta Co-Pay Assist Program aforementioned. Often the link is between the drug sales rep and your doc. Good luck, Jim

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[Anonymous]

I went through a similar situation with the Brand name Ritilan (I am in canada too) I also have extended health prescription drug coverage. I started on the Brand name drug and it worked very well, the pharmacy then changed me to generic without telling me the second time, I got really angry!

I called the pharmacy to ask why they did this, the answer was that it was cheaper and my extended health didn’t want to cover it (even though they did the first time!

The idea was after 30 days supply my extended heath only covered the 80% cost of the generic brand as there was a generic available of this drug. It would not cover 80% of the brand name!

I called the extended health company and they said that if the prescribing physician wrote a note on my prescription saying brand name Only then my extended would cover the full 80% of the Brand name, essentially I pay the same for the Brand name as I would’ve for the generic!

I should say too that the pharmacy had no idea that this was possible and tried to deny it the first time, I had to make them call and ask the extended health company themselves! It was a process and took about an hour for them to figure it out but the price differance is about $12 a month, money well saved IMO

Well trying to solve the 3 month supply problem……I am extremely intense when I talk to people and generally if I want something to go a certain way I will fight for it lol! If you feel comfortable confronting the issue here is what I would do. I would call the pharmacy that filled it, calmly ask if this is a busy time or if there is a slower time of the day to call, if the person is busy they are not going to listen to what you have to say. I would calmly explain the situation (if you write point form notes before hand I find it helps with tje blank moments or confusion) I would explain that as a student you are unable to afford the cost or replacing the whole prescription and they were the ones that substituded in the first place when clearly looking at your past history you have always had the Brand name. Ask them to replace it for you and offer to pay their dispensing fee if necessary. If this doesn’t get you anywhere ask to talk to their supervisor generally this either gets immediate helpful results or you actually will have to explain all over again to the supervisor. I use the same process with the supervisor and if still no results I would go to the store owner or if its a chain store head office!

9 times out of 10 I get results just by asking to speak to the supervisor if nothing works I threaten to use a different store/company lol! I use this process for a lot of things that I am unhappy about, bill amounts and screwups. Restaurants when they srew up your food or provide crappy service, stores that refuse to let you return something etc. You would be surprised at the results and free stuff people will practically throw at you in order to keep your business! Well maybe its (adhd) and they just want me to ultimately shut up or go away lol!

Good luck! I am a firm believer of self advocating!

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[foogol]

@fortheloveofcats:

The active ingredient is the same but the binder is not, and one of lower quality.. As per active ingredient, quality and manufacture, that too depends as well.. I don’t see why your doctor would change to generic unless it was cost effective for you….–foogol

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[AbbyNormal]

Totally had the same trouble with generic Concerta!!!!! Was so excited about the cheaper generic. Met a woman at the doc’s office that told me her son had to change back to regular from generic because it didn’t work as well and a LIGHT BULB clicked on over my head! I looked back at the previous month and realized why I’d been in a fog!! Had NO idea the quality and effects could be subpar, but they were, for me!!

Am now back on “no substitution” Concerta and SO glad for random strangers!

Hope you find a way to get your supply changed. That’s a long time to wait, so sorry!!

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[foogol]

@JimC.:

Great link thanks.. I believe if not mistaken I saw varies video’s on an almost same subject with Rick Green.. Can’t find the link for Greene’s video at the moment… 🙄

💡 Alright I found it.. There are four video’s and talk about Generic Medication- http://www.youtube.com/watch?v=CWT3o0XtjRQ

–foogol

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[Cyclone]

Here’s what you can tell your mother…

The generic, Teva-Methylphenidate, is NOT the same as Concerta. They have the same drug in the same quantities but the similarity ends there. The release mechanism is NOT the same and this is what matters about Concerta.

What to do?

Ask your doctor for a Co-assist card for Concerta. If you can’t see your doctor because you are away from home, visit the University health center instead; a doctor there should be able to provide you with one. It will cover the difference in cost between Teva-Methylphenidate and Concerta (which is about 50% cheaper). If there are no refills remaining on your prescription you’ll need a new one.

Unfortunately, you will have to return the rest of your current pills to the pharmacist for destruction as it is a controlled substance. The law does not allow them to exchange the pills. However, if you have insurance you can submit the expense of the replacements with an explanation of what occurred, so it should only leave you out of pocket temporarily.

Why are they different?

Concerta features a slow release capsule technology that was developed at MIT. The capsule actually remains intact as it moves through your system. It is coated with a small amount of the drug which is released right away. The remainder of the drug is released over an 8 to 12 hour period (depending on how your body metabolizes it). This slow release is achieved by a passive “pump” mechanism.

You can imagine the Concerta tablet as being like a tiny syringe. A membrane at one end allows fluid to slowly enter the tablet. As the fluid enters, a small hole at the other end allows the drug to be pushed out. This is what provides the slow, even delivery.

Teva-Methylphenidate, on the other hand, is a slow release compressed powder pill. Its “slow” release is achieved by packing the drug between layers of slow dissolving material. As the pill dissolves, new layers are exposed and released.

While both achieve a time released effect, the latter approach is more like taking two pills at different times. The first is released within an hour of consumption, the second a few hours later. This results in two distinctive peaks, a big one followed by a huge one, after which the effect tapers off. In comparison, there is no peak with Concerta.

If your mother still resists, tell her that it’s OK now that you discovered the generic could be crushed and snorted; something you could never do with Concerta!

How did things go so wrong?

The generic drug makers would like you to believe they are providing an important service, selling drugs at a price representative of their manufacturing costs rather than charging the “unreasonable” brand name prices. Brand name drugs are more expensive because these companies spend a lot of money developing the drugs. These are fixed costs that must be recovered, so the price of the drug must be greater than the cost of manufacturing (plus some profit). The generics want to leverage the research without paying the price.

This case reveals how greedy the generics really are. Teva took Janssen Ortho to court to argue their drug was the same and the delivery mechanism shouldn’t be part of the patent. In essence, they said it doesn’t matter that the delivery is different. The courts agreed. The impact on patients wasn’t considered. Unfortunately the laws in some provinces don’t require generics to have the same delivery mechanism. This case proves that this needs to be rethought, and it is. In this case the delivery mechanism is everything!

The generic maker didin’t care whether you got what you need. They just fought for the right to replace your brand name drug, at any cost.

I hope this helps and wish you all the best with your schooling.

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[jennifermac]

We recently had this issue with generic substitution with our daughter. It was her first prescription and I had asked for Concerta but the pharmacy substituted the generic without telling us! I didn’t realize for weeks until my mother asked if I was sure the script was right. I was furious that the pharmacy had done this and upon calling them was given a line about it being the law in N.S.. My Doctor was frustrated as well. We have since had a “no substitutes” script filled and noticed a definite improvement in release time as expected. If I hadn’t known the difference I would have asked for an increase in dosage, and may have ended up one of those people over-medicating their kids in an attempt to get the effect of Concerta extended release. How are we supposed to make informed decisions about these meds. if the pharmacist can switch them around and not even tell us! She claimed ignorance of the issue by the way. She said she hadn’t had any complaints and wasn’t aware of any issues. When you hear of kids having adverse reactions to these medications I have to wonder if anyone really has their facts straight!!

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[Scattybird]

You need to check your meds carefully when you pick them up. It’s particularly important they don’t substitute a generic for Concerta because the release mechanism is less effective.

I take fast release Ritalin. My pharmacist was fussing around last time I took a script in because my psych had writtten methylphenidate and Ritalin and highlighted that I was to be dispensed Ritalin. When I went back in to collect the meds the pharmacist was concerned because she could only find my Ritalin but not the methylphenidate – she thought the prescription meant two items and didn’t even look embarassed when I told her one was the brand name and the other the chemical name. Oh well…. It made a change from dealing with the usual one who clearly thinks I’m some old fruit loop. (She’s right…but that’s not the point!)

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