This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related article  • Related letters  • Similar articles in JAMA  Topic Collections  • Aging/ Geriatrics  • Cardiovascular System  • Arrhythmias  • Cardiovascular Disease/ Myocardial Infarction  • Drug Therapy  • Drug Therapy, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their systematic review and meta-analysis, Dr Kesselheim and colleagues¹ assessed the equivalence of generic and brand-name drugs for cardiovascular disease. Several studies that I participated in were evaluated by the authors,^2-4 and I generally agree with their conclusions. However, it is important to consider the limitations of current scientific evidence.

Most studies comparing generics to brand-name drugs use normal volunteers or relatively healthy patients. Tables 1, 2, and 3 in the study by Kesselheim et al indicate that 57% of the studies involved healthy volunteers. Pharmaceutical parameters such as tablet strength, dissolution, binding excipients, and the resulting absorption determine equivalence between generics and brand drugs. Although these characteristics may be fairly consistent in homogeneous healthy young participants, they can be very different among heterogeneous older patients because physiologic parameters change with age or disease. Small changes in something as apparently minor as the rate at which . . . [Full Text of this Article]

Barry L. Carter, PharmD
barry.carter@uiowa.edu
Division of Clinical and Administrative Pharmacy
College of Pharmacy
University of Iowa
Iowa City

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Clinical Equivalence of Generic and Brand-Name Drugs Used in Cardiovascular Disease: A Systematic Review and Meta-analysis
, , , , , , and
JAMA. ;300():2514-2526.
FULL TEXT  

RELATED LETTERS

Equivalence of Generic and Brand-Name Drugs for Cardiovascular Disease

JAMA. ;301():1654-1655.
FULL TEXT  

Equivalence of Generic and Brand-Name Drugs for Cardiovascular Disease

JAMA. ;301():1655-1655.
FULL TEXT  

Equivalence of Generic and Brand-Name Drugs for Cardiovascular Disease--Reply
, , and
JAMA. ;301():1655-1656.
FULL TEXT