The more money that doctors receive from drug companies in the form of meals, travel arrangements and ownership royalties, the less likely they were to prescribe by generic name. Seeing drug company sales representatives more frequently is associated with more brand name prescribing, which translates into more expensive prescribing. Sales reps also usually leave out important safety information about drugs they are promoting, so besides prescriptions costing more, they might also be more likely to harm patients.
Brand names, drug regulation (the domain of Health Canada) and pharmaceutical promotion have come together in a particularly egregious way in the case of buprenorphine-naloxone, brand name Suboxone — an opioid medication used to treat opioid addiction.
Even though generic formulations of the drug have been available in Canada since 2013 (and even earlier in the United States), the drug is widely referred to by its brand name, including in the media, by policy makers and by doctors.
One way this happened was through the promotion of an “educational” program developed and delivered by Indivior, the company that holds the rights to Suboxone. In some provinces, completing this branded program is a pre-requisite to being able to prescribe buprenorphine-naloxone. The same strategy has been executed for a related injectable form of buprenorphine, also owned by Indivior.
This use of the branded program is the case even though there are perfectly good, accredited, non-industry educational programs already available to teach appropriate opioid addiction care and prescribing to doctors, nurses and pharmacists.
The inclusion of the brand name in the title of this program flies in the face of recommended practices and accreditation standards for Canadian medical education programs.
Yet, the branded program is fully sanctioned by Health Canada through that body’s review and approval of the Suboxone product monograph. This document, which describes the nature of the drug and its approved uses in Canada, includes a description of the requirement for participation in the branded “training program.”
As has been documented in the U.S., Indivior and its parent company Reckitt Benckiser have engaged in a variety of unscrupulous practices to promote their multibillion-dollar buprenorphine product line — ultimately paying some of the largest fines in U.S. pharmaceutical history. In this light, a branded “educational” program seems to be one more vehicle for brand name promotion, and one in which Health Canada is directly complicit.
When doctors use brand names they may be less knowledgeable about the drugs they are prescribing, their prescriptions cost more and patients may be more likely to suffer side-effects. When Health Canada prioritizes brand names over generic names it is actively contributing to all these problems.
Health Canada should know better and must do better.
This article is republished from The Conversation under a Creative Commons license. Read the original article.