Are you on generics?

Are you on generics?
© European Union 2012
This was the insult uttered by the Greek deputy PM and Minister of Foreign Affairs Evangelos Venizelos, during the parliamentary discussion about whether the defense contracts signed during Venizelos’ tenure as Minister of National Defense be investigated. It is a variation of the commonly used phrase 'are you on drugs?' (which has its equivalent in Greek, too). 






But why is it so bad for someone to be on generics? Do generics cause hallucinations, unexplained changes in behaviour, increased risk of infection, etc. etc.?  The changeover from prescribing drugs by brand name over to prescribing by active ingredient is currently underway, and has been met with considerable resistance, from the pharmaceutical industry, doctors and the public. So for the deputy PM to shout this phrase at the opposition's parliamentary spokesman has two effects: 1) it demonstrates a fundamental lack of understanding of what generics actually are and 2) shows contempt towards the cheaper (but equally effective) option.


So, are generics likely to cause one to ask inappropriate questions in a parliamentary discussion, or exhibit otherwise erratic behavior? Actually, no. Generics are produced once the patent monopoly on medicines runs out (after 20 or so years generally).

To imply that a cheaper but equally effective option as undesirable therefore indicates that this government probably has its priorities for health care quite wrong


They are cheaper than the patented drugs for this reason (though not that much cheaper in Greece). They are equally as safe as patented drugs, provided they have not been counterfeited or imported illegally. Unlike illegal drugs, generics target the ailment they are supposed to treat, and side-effects of their active ingredients are studied systematically and extensively both before and after they are released on the market. Therefore, Venizelos’ neologism is invalid on this count.


Generics also save money for the ailing health care system. Equating them to out-of-date drugs, as the Greek phrase goes, is to indicate that generics are not only unsafe for human consumption and cause unpredictable effects, but are also undesirable compared to the ‘original’ patented drug. To declare this in a state of humanitarian emergency, in which the health care system is unable to provide basic services, and in which the supply of trivial materials such as gloves, syringes and masks is scarce, is at the very least ignorant, if not outright callous. To imply that a cheaper but equally effective option as undesirable therefore indicates that this government probably has its priorities for health care quite wrong. The funny thing is that, on the one hand, a purchaser/provider split is being introduced, access to health care is barred through the introduction of payment at the point of care, while on the other hand, the deputy PM makes a comment that indicates that the changeover to generics is undesirable, on account of generics being equivalent to out-of-date drugs. Might the cost-saving measures therefore be a little one-sided?


Fundamentally, the conception of health care is that of a two-tier system. On the one hand, a system in which those who can afford to pay for ‘premier services’, which include patented drugs, and, on the other hand, a system in which ‘the rest’ are provided with substandard care and prescribed the contemptible generics. This appears to be the government’s ‘generic’ approach to health care, which, ironically, is being touted as being a priority.


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