[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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