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Wang CY, Chen CH, Tu CY, Chen WC, Kuo LK, Wang YT, Fu PK, Ku SC, Fang WF, Chen CM, Lai CC. Clinical effectiveness of branded versus generic piperacillin-tazobactam for treating severe community-acquired pneumonia. J Infect Public Health 2022; 15:961-965. [DOI: 10.1016/j.jiph.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/16/2022] [Accepted: 07/19/2022] [Indexed: 10/17/2022] Open
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2
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Zhao Y, Hu C, Yao S, Yin L, Ling X. A strategy for population pharmaceutical quality assessment based on quality by design. J Pharm Anal 2021; 11:588-595. [PMID: 34765271 PMCID: PMC8572710 DOI: 10.1016/j.jpha.2020.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 11/30/2022] Open
Abstract
From a regulatory perspective, drug quality consistency evaluation must concern different processes used for the same drug. In this study, an assessment strategy based on quality by design (QbD) was developed for population pharmaceutical quality evaluation. A descriptive analysis method based on QbD concept was first established to characterize the process by critical evaluation attributes (CEAs). Then quantitative analysis method based on an improved statistical process control (SPC) method was established to investigate the process indicators (PIs) in the process population, such as mean distribution, batch-to-batch difference and abnormal quality probability. After that rules for risk assessment were established based on the SPC limitations and parameters. Both the SPC parameters of the CEAs and the risk of PIs were visualized according to the interaction test results to obtain a better understanding of the population pharmaceutical quality. Finally, an assessment strategy was built and applied to generic drug consistency assessment, process risk assessment and quality trend tracking. The strategy demonstrated in this study could help reveal quality consistency from the perspective of process control and process risk, and further show the recent development status of domestic pharmaceutical production processes. In addition, a process risk assessment and population quality trend tracking provide data-based information for approval. Not only can this information serve as a further basis for decision-making by the regulatory authority regarding early warnings, but it can also reduce some avoidable adverse reactions. With continuous addition of data, dynamic population pharmaceutical quality is meaningful for emergencies and decision-making regarding drug regulation.
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Affiliation(s)
- Yu Zhao
- NMPA Key Laboratory for Quality Research and Evaluation of Chemical Drugs, National Institutes for Food and Drug Control, Beijing, 102629, China
- Acedemy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100088, China
| | - Changqin Hu
- NMPA Key Laboratory for Quality Research and Evaluation of Chemical Drugs, National Institutes for Food and Drug Control, Beijing, 102629, China
| | - Shangchen Yao
- NMPA Key Laboratory for Quality Research and Evaluation of Chemical Drugs, National Institutes for Food and Drug Control, Beijing, 102629, China
| | - Lihui Yin
- NMPA Key Laboratory for Quality Research and Evaluation of Chemical Drugs, National Institutes for Food and Drug Control, Beijing, 102629, China
| | - Xiaomei Ling
- Peking University Health Science Center, Peking University, Beijing, 100191, China
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Yang P, Fujimura S, Du Y, Zhang B, Yang L, Kawamura M, Zhang Z, Zhai S. Comparison of Pharmaceutical Characteristics between Brand-Name Meropenem and Its Generics. Antibiotics (Basel) 2021; 10:antibiotics10091096. [PMID: 34572677 PMCID: PMC8469160 DOI: 10.3390/antibiotics10091096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/04/2021] [Accepted: 09/08/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to provide comparative information of pharmaceutical properties, including particle morphology and distribution uniformity, solubility, presence of residual solvent and insoluble particles, and antimicrobial activities, between brand-name meropenem (Mepem®, BNM) and its six generic products (GPs A-F) marketed in China. Particles of GP-A and -C in dry powder had similar diameters of BNM, while other GPs were larger. Only BNM and GP-A were completely dissolved within 100 s in the lab condition. No insoluble particles >25 μm in diameter were detected in BNM and GP-E. Regarding stability of GPs solutions evaluated by concentration of open-ring metabolites at 6 h and 8 h, BNM showed the lowest open-ringed metabolite concentrates. Residual solvent of acetone detected in one GP showed the maximum value, while ethanol and ethyl acetate were detected both in product E and product F. The concordance rates (%) of minimum inhibitory concentration (MIC) of each generic compared to BNM were 89.5, 85, 87.5, 88, 88.5, and 86.5, respectively, although no significant difference was reached in MIC. Pharmaceutical characteristic differences between the BNM and GPs identified in this study could provide insights into understanding the deviations in the drug manufacturing processes of generic drugs.
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Affiliation(s)
- Ping Yang
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; (P.Y.); (Y.D.); (B.Z.); (L.Y.)
| | - Shigeru Fujimura
- Division of Clinical Infectious Diseases & Chemotherapy, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Japan;
- Correspondence: (S.F.); (S.Z.)
| | - Yawei Du
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; (P.Y.); (Y.D.); (B.Z.); (L.Y.)
| | - Bei Zhang
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; (P.Y.); (Y.D.); (B.Z.); (L.Y.)
| | - Li Yang
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; (P.Y.); (Y.D.); (B.Z.); (L.Y.)
| | - Masato Kawamura
- Division of Clinical Infectious Diseases & Chemotherapy, Tohoku Medical and Pharmaceutical University, Sendai 981-8558, Japan;
| | - Zhenhua Zhang
- Department of Medical Affairs, Sumitomo Pharmaceuticals (Suzhou) Co. Ltd., Shanghai 200025, China;
| | - Suodi Zhai
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China; (P.Y.); (Y.D.); (B.Z.); (L.Y.)
- Correspondence: (S.F.); (S.Z.)
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Zhang SH, Wei SS, Zhu ZY, Chen Y, Cai HL, Zhang BK. Physicochemical Assessment of Branded and Generic Linezolid Injection from Different Pharmaceutical Manufacturers. CURR PHARM ANAL 2021. [DOI: 10.2174/1573412916666200224104617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Up to date, generic linezolid injections produced by Chinese manufacturers
were not widely used in clinics in China. Quality evaluation of linezolid injections produced in China
is a prerequisite, which has rarely been performed.
Objective:
This study aimed to evaluate the quality of branded and generic injections from different
manufacturers and to provide a basis for quality control.
Methods:
In this study, the content of linezolid, related impurities and enantiomer of linezolid were
determined by high-performance liquid chromatography. The content of glucose was determined by the
iodine method. The insoluble particles and visible and sub-visible particles were determined by light
blockage and lamp test, respectively. Osmotic pressure was determined by the freezing point depression
method. The standard solution control method was used to check the color of the injection. Linezolid
injections from different manufacturers were evaluated uniformly.
Results:
No significant difference was found in the content of linezolid, glucose, related impurities,
visible particles, insoluble particles, pH value, and solution color between branded and generic drugs
from different manufacturers in China.
Conclusion:
The quality of samples from different manufacturers is consistent. Although the physicochemical
similarity does not guarantee the bioequivalence of studied branded and generic linezolid injections,
the results provide references for further bioequivalence study. Generic injections offer more
affordable treatment options for patients with infections than expensive branded drugs.
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Affiliation(s)
- Su-hua Zhang
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha 410011,China
| | - Shan-shan Wei
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha 410011,China
| | - Zhen-yu Zhu
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha 410011,China
| | - Ying Chen
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha 410011,China
| | - Hua-lin Cai
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha 410011,China
| | - Bi-kui Zhang
- Department of Pharmacy, Second Xiangya Hospital, Central South University, Changsha 410011,China
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Sheu MJ, Chen CC, Lu YC, Su BA, Zhang CC, Wang SS, Chuang YC, Tang HJ, Lai CC. In Vitro Antimicrobial Activity of Various Cefoperazone/Sulbactam Products. Antibiotics (Basel) 2020; 9:antibiotics9020077. [PMID: 32059590 PMCID: PMC7168170 DOI: 10.3390/antibiotics9020077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Abstract
: This study aims to assess the in vitro activity of different samples of cefoperazone/sulbactam (CFP/SUL) against multidrug-resistant organisms (MDROs). Clinical isolates of extended-spectrum β-lactamase (ESBL)-Escherichia coli, ESBL-Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii (CR-AB), and carbapenem-resistant Pseudomonas aeruginosa (CR-PA) were collected. The minimum inhibitory concentration (MIC) and time-killing methods were used to assess and compare the in vitro activities of different samples of cefoperazone/sulbactam (CFP/SUL) against these MDROs. For ESBL-E. coli, ESBL-K. pneumoniae, and CR-PA, product C had smaller variations than product A and B (p < 0.05). For CR-AB, product B had the largest variation compared to the other two products (p < 0.05). In the time-killing studies, significant differences among the products when used at 16/16 µg/mL were noted for ESBL-E. coli, ESBL-K. pneumoniae, and CR-AB isolates. In conclusion, this study demonstrated the significantly different activity of different products of CFP/SUL against MDROs.
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Affiliation(s)
- Ming-Jen Sheu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan;
- Department of Medicinal Chemistry, Chia Nan University of Pharmacy & Science, Tainan 717, Taiwan
| | - Chi-Chung Chen
- Department of Medical Research; Chi Mei Medical Center; Tainan 710, Taiwan; (C.-C.C.); (Y.-C.L.)
- Department of Food Science, National Chiayi University, Chiayi 717, Taiwan
| | - Ying-Chen Lu
- Department of Medical Research; Chi Mei Medical Center; Tainan 710, Taiwan; (C.-C.C.); (Y.-C.L.)
| | - Bo-An Su
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
| | - Chun-Cheng Zhang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
| | - Shu-Shen Wang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
| | - Yin-Ching Chuang
- Department of Medicinal Chemistry, Chia Nan University of Pharmacy & Science, Tainan 717, Taiwan
- Department of Food Science, National Chiayi University, Chiayi 717, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
- Correspondence: (H.-J.T.); (C.-C.L.)
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 710, Taiwan
- Correspondence: (H.-J.T.); (C.-C.L.)
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Comparative in vitro antimicrobial potency, stability, colouration and dissolution time of generics versus innovator of meropenem in Europe. Int J Antimicrob Agents 2019; 55:105825. [PMID: 31634551 DOI: 10.1016/j.ijantimicag.2019.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/11/2019] [Indexed: 01/01/2023]
Abstract
Meropenem generics are often imposed on prescribers, however scarce information is available on key properties such as antimicrobial potency, stability and colouration in solution, and dissolution time. This study aimed to generate comparative information for products available in Europe. The originator (ASTRA) and four generics (HOSPIRA, SANDOZ, FRESENIUS and AUROVIT) were compared for: (i) MICs against Pseudomonas aeruginosa clinical isolates (range, 0.125-191 mg/L); (ii) colouration (visual and photometry) and stability of concentrated solutions for prolonged or continuous infusion and maintained at 25-37 °C for up to 8 h (acceptable limit, ≥90% of original concentration); and (iii) dissolution time of concentrated solutions (50 mg/mL [for bolus administration]: turbidimetry and nursing personnel assessment). No significant difference was observed for MICs (except 2/80 isolates). For concentrated solutions storage: (i) SANDOZ produced about two times more yellow-coloured degradation products than the other preparations; (ii) meropenem loss was time-, concentration- and temperature-dependent; (iii) FRESENIUS was the least stable (limit for 1 g/48 mL, ~8 h at 25 °C and 4.5 h at 37 °C); (iv) at 2 g/48 mL, the storage time limit was 5-6 h at 25 °C and ~3 h at 37 °C for all preparations. Complete dissolution (turbidimetry) required 240 s for generics (120 s for ASTRA), and nurses reported longer but highly variable times for generics. Substantial differences between innovator and generics have been identified that could impact on their clinical use and/or make multicentric studies difficult to interpret, requiring suitability studies in the environments of their intended use.
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Takazawa T, Murooka Y, Saito S. Is it just a cefazolin issue? JA Clin Rep 2019; 5:61. [PMID: 32026026 PMCID: PMC6966946 DOI: 10.1186/s40981-019-0281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 09/05/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Tomonori Takazawa
- Intensive Care Unit, Gunma University, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Yukie Murooka
- Intensive Care Unit, Gunma University, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Shigeru Saito
- Intensive Care Unit, Gunma University, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
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Clinical and economic impact of generic versus brand name meropenem use in an intensive care unit in Colombia. Braz J Infect Dis 2019; 23:237-245. [PMID: 31344357 PMCID: PMC9427813 DOI: 10.1016/j.bjid.2019.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 06/13/2019] [Accepted: 06/16/2019] [Indexed: 01/08/2023] Open
Abstract
Background Recent studies suggest that sustained use of generic antibiotics may be associated with clinical failure and emergence of antibacterial resistance. The present study was designed to determine the clinical outcome between the use of generic meropenem (GM) and brand-name meropenem (BNM). Additionally, this study evaluated the economic impact of GM and BNM to determine if the former represents a cost-effective alternative to the latter. Methods Patients treated between January 2011 and May 2014 received GM while patients treated between June 2014 and March 2017 received BNM. Mortality was compared between groups. Total infection cost was defined by the cost of antimicrobial consumption, length of stay, and laboratory and imaging exams until infection resolution. Findings A total of 168 patients were included; survival rate for the 68 patients treated with GM was 38% compared to 59% in the patients treated with BNM. Multivariate analysis showed that the variables most strongly-associated with mortality were cardiovascular disease (OR 18.18, 95% CI 1.25–262.3, p = 0.033) and treatment with generic meropenem (OR 18.45, 95% CI 1.45–232.32, p = 0.024). On the other hand, total infection cost did not show a significant difference between groups (BNM $10,771 vs. GM $11,343; p = 0.91). Interpretation The present study suggests that patients treated with GM have a risk of death 18 times higher compared to those treated with BNM. Furthermore, economic analysis shows that GM is not more cost effective than BNM. Summary More studies measuring clinical outcomes are needed to confirm the clinical equivalence of brand-name versus generic antibiotics, not only for meropenem but also for other molecules.
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Agudelo M, Rodriguez CA, Zuluaga AF, Vesga O. Nontherapeutic equivalence of a generic product of imipenem-cilastatin is caused more by chemical instability of the active pharmaceutical ingredient (imipenem) than by its substandard amount of cilastatin. PLoS One 2019; 14:e0211096. [PMID: 30726248 PMCID: PMC6364906 DOI: 10.1371/journal.pone.0211096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background We demonstrated therapeutic nonequivalence of “bioequivalent” generics for meropenem, but there is no data with generics of other carbapenems. Methods One generic product of imipenem-cilastatin was compared with the innovator in terms of in vitro susceptibility testing, pharmaceutical equivalence, pharmacokinetic (PK) and pharmacodynamic (PD) equivalence in the neutropenic mouse thigh, lung and brain infection models. Both pharmaceutical forms were then subjected to analytical chemistry assays (LC/MS). Results and conclusion The generic product had 30% lower concentration of cilastatin compared with the innovator of imipenem-cilastatin. Regarding the active pharmaceutical ingredient (imipenem), we found no differences in MIC, MBC, concentration or potency or AUC, confirming equivalence in terms of in vitro activity. However, the generic failed therapeutic equivalence in all three animal models. Its Emax against S. aureus in the thigh model was consistently lower, killing from 0.1 to 7.3 million less microorganisms per gram in 24 hours than the innovator (P = 0.003). Against K. pneumoniae in the lung model, the generic exhibited a conspicuous Eagle effect fitting a Gaussian equation instead of the expected sigmoid curve of the Hill model. In the brain infection model with P. aeruginosa, the generic failed when bacterial growth was >4 log10 CFU/g in 24 hours, but not if it was less than 2.5 log10 CFU/g. These large differences in the PD profile cannot be explained by the lower concentration of cilastatin, and rather suggested a failure attributable to the imipenem constituent of the generic product. Analytical chemistry assays confirmed that, besides having 30% less cilastatin, the generic imipenem was more acidic, less stable, and exhibited four different degradation masses that were absent in the innovator.
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Affiliation(s)
- Maria Agudelo
- GRIPE: Grupo Investigador de Problemas en Enfermedades Infecciosas, University of Antioquia (UdeA) Medical School, Medellín, Colombia
- Infectious Diseases Unit, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Carlos A. Rodriguez
- GRIPE: Grupo Investigador de Problemas en Enfermedades Infecciosas, University of Antioquia (UdeA) Medical School, Medellín, Colombia
- CIEMTO: Centro de Información de Medicamentos y Tóxicos, University of Antioquia (UdeA) Medical School, Medellín, Colombia
| | - Andres F. Zuluaga
- GRIPE: Grupo Investigador de Problemas en Enfermedades Infecciosas, University of Antioquia (UdeA) Medical School, Medellín, Colombia
- CIEMTO: Centro de Información de Medicamentos y Tóxicos, University of Antioquia (UdeA) Medical School, Medellín, Colombia
| | - Omar Vesga
- GRIPE: Grupo Investigador de Problemas en Enfermedades Infecciosas, University of Antioquia (UdeA) Medical School, Medellín, Colombia
- Infectious Diseases Unit, Hospital Universitario San Vicente Fundación, Medellín, Colombia
- * E-mail:
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Lin YS, Jan IS, Cheng SH. Comparative analysis of the cost and effectiveness of generic and brand-name antibiotics: the case of uncomplicated urinary tract infection. Pharmacoepidemiol Drug Saf 2016; 26:301-309. [PMID: 27862588 DOI: 10.1002/pds.4122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 10/06/2016] [Accepted: 10/11/2016] [Indexed: 11/11/2022]
Abstract
PURPOSE Generic medications used for chronic diseases are beneficial in containing healthcare costs and improving drug accessibility. However, the effects of generic drugs in acute and severe illness remain controversial. This study aims to investigate treatment costs and outcomes of generic antibiotics prescribed for adults with a urinary tract infection in outpatient settings. METHODS The data source was the Longitudinal Health Insurance Database of Taiwan. We included outpatients aged 20 years and above with a urinary tract infection who required one oral antibiotic for which brand-name and generic products were simultaneously available. Drug cost and overall healthcare expense of the index consultation, healthcare cost during a 42-day follow-up period, and treatment failure rates were the main dependent variables. Data were compared between brand-name and generic users from the entire cohort and a propensity score-matched samples. RESULTS Results from the entire cohort and propensity score-matched samples were similar. Daily antibiotic cost was significantly lower among generic users than brand-name users. Significant lower total drug claims of the index consultation only existed in patients receiving the investigated antibiotics, while the drug price between brand-name and generic versions were relatively large (e.g., >50%). The overall healthcare cost of the index consultation, healthcare expenditure during a 42-day follow-up period, and treatment failure rates were similar between the two groups. CONCLUSIONS Compared with those treated with brand-name antibiotics, outpatients who received generic antibiotics had equivalent treatment outcomes with lower drug costs. Generic antibiotics are effective and worthy of adoption among outpatients with simple infections indicating oral antibiotic treatment. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Yu-Shiuan Lin
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - I-Shiow Jan
- National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shou-Hsia Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
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Shibata H, Yoshida H, Izutsu KI, Yomota C, Goda Y, Okuda H. Scientific and regulatory approaches to confirm quality and improve patient perceptions of generic drug products in Japan. AAPS OPEN 2016. [DOI: 10.1186/s41120-016-0008-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Sun HY, Liao HW, Sheng MH, Tai HM, Kuo CH, Sheng WH. Bioequivalence and in vitro antimicrobial activity between generic and brand-name levofloxacin. Diagn Microbiol Infect Dis 2016; 85:347-351. [PMID: 27181716 DOI: 10.1016/j.diagmicrobio.2016.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/18/2016] [Accepted: 04/23/2016] [Indexed: 01/07/2023]
Abstract
Generic agents play a crucial role in reducing the cost of medical care in many countries. However, the therapeutic equivalence remains a great concern. Our study aims to assess the in vitro antimicrobial activity and bioequivalence between generic and brand-name levofloxacin. Enantiomeric purity test, dissolution test, and in vitro antimicrobial susceptibility against seven clinically important pathogens by the agar dilution method were employed to assess the similarity between four generic products and brand-name levofloxacin (Daiichi Sankyo). All the generic and brand-name levofloxacin passed enantiomeric purity test. The results of dissolution tests were not similar among the generic products and the brand-name levofloxacin. Compared with the generic products, the brand-name levofloxacin had the smallest mean variations (-25% to 13%) with reference standard (United States Pharmacopeia levofloxacin Reference Standards). Variations were observed particularly in dissolution profiles and in vitro activity between generic products and brand-name levofloxacin.
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Affiliation(s)
- Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Wei Liao
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Hui-Min Tai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Toutain PL, Bousquet-Melou A. Rebuttal to the reaction of the EGGVP to the review article 'the consequences of generic marketing on antibiotic consumption and the spread of microbial resistance: the need for new antibiotics'. J Vet Pharmacol Ther 2015; 37:618-23. [PMID: 25399727 DOI: 10.1111/jvp.12166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P L Toutain
- Ecole Nationale Veterinaire de Toulouse, Toulouse, France
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Takizawa O, Urushihara H, Tanaka S, Kawakami K. Price difference as a predictor of the selection between brand name and generic statins in Japan. Health Policy 2015; 119:612-9. [PMID: 25697888 DOI: 10.1016/j.healthpol.2015.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 01/07/2015] [Accepted: 01/15/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aimed to explore the predictors of the selection between brand name drug (BR) and generic drug (GE) and to clarify the quantitative relationship about selection. METHODS We identified "incident users" who dispensed statins between April 2008 and June 2011 in commercially databases consisted of dispensing claims databases (DCD) of out-of-hospital pharmacies and hospital claims databases (HCD) of in-house pharmacies in Japan. Predictors of the selection between BR and GE, including price difference (PD), the price of BR, their interaction and percent change of the price of GE relative to BR were explored by logistic regression using DCD and HCD separately. RESULTS We extracted records of 670 patients who have opportunity for selection both BR and GE. Logistic regression analysis demonstrated that PD, the price of BR, interaction between them, and prescriber affiliation were factors significantly associated with the selection in the DCD; logit (p)=9.735-0.251×PD-0.071×the price of BR+0.002×PD×the price of BR-1.816×affiliation+0.220×gender-0.008×age+0.038×monthly medical fee. PD was inversely proportional to BR choice in DCD and lead to the opposite result in HCD. Numerical simulation of selection revealed that the quantitative relationships heavily depend on situations. CONCLUSIONS PD and the price of BR are predictors of the selection between BR and GE interactively in out-of-hospital pharmacies, but not in in-house pharmacies of medical facilities. Results may support policies which increase the power of out-of-hospital pharmacies for selection.
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Affiliation(s)
- Osamu Takizawa
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Hisashi Urushihara
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Shiro Tanaka
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
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