Are generic immunosuppressants safe and effective? Clinical experience is reassuring and regulation is strict, now we need definitive evidence

Godman, B and Baumgärtel, C (2015) Are generic immunosuppressants safe and effective? Clinical experience is reassuring and regulation is strict, now we need definitive evidence. BMJ. 350. ISSN 1756-1833 (https://doi.org/10.1136/bmj.h3248)

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Abstract

Increasing use of generic drugs is essential to maintain comprehensive and equitable healthcare, given current pressure on budgets through, for instance, ageing populations. Initiatives among health authorities to promote generic prescribing include educational initiatives (which in the United Kingdom has resulted in high levels of prescribing of international non-proprietary name (INN) drugs in over 80% of all prescriptions), compulsory generic substitution in pharmacies, and patients paying extra “out of pocket” expenses for a proprietary drug.[1-3] Concerns remain, however, about generic prescribing or compulsory substitution in certain drugs and drug classes, including lithium, theophyllines, some anti-epileptic drugs, and the immunosuppressants evaluated in the linked study by Molnar and colleagues (doi:10.1136/bmj.h3163).