Pharmaceutical companies lobbying States to restrict use of lower-cost generic alternatives

Pharmaceutical companies, which "have been waging war against inexpensive generic drugs for years at the national level," are now "taking their fights to the states, promoting proposals that would" bar pharmacists from automatically replacing prescriptions for brand-name drugs with generics, the Baltimore Sun reports.

Measures that would prohibit pharmacists from automatically replacing certain brand-name drugs with generic counterparts have been considered in 27 states and have been adopted by two states over the last two years, according to the National Association of Chain Drug Stores.

The legislation would require pharmacists to inform physicians or to seek their approval before making the switch to the lower-cost alternatives. Most of the bills in state Legislatures would apply to all generic drugs, while some are focused on certain types of drugs. Once a generic is approved by FDA as safe and effective, states can allow local pharmacies to substitute the generic for its brand-name counterpart.

Drug makers, who actively support the bills, say the practice of replacing drugs with generics causes harm to patients because a slight difference in formulation or manufacturing can cause side effects. Opponents say these measures would "undermine a key effort" to control health care costs, the Sun reports. Opponents also note that three brand-name epilepsy drugs, which commonly are targeted in non-comprehensive state bills, have more than $5 billion in annual sales and are scheduled to lose patent exclusivity this year.

The bills are "putting a fix to a problem that doesn't exist," Lawrence Brown, director of the Center for Medication Therapy Management at the University of Tennessee Health Science Center, said. Laureen Cassidy -- a spokesperson for Abbott Laboratories, a drug maker whose support for the legislation is "limited" -- said, "For most patients," obtaining permission from their physicians to switch to a lower-cost generic drug "isn't a problem, but for select patients it can be." She added that Abbott hopes that debate over the bills will focus attention on the need to customize treatment for individual patients (Rockoff, Baltimore Sun, 6/17).