Generic meds, pharmacists and how they affect patients
Your Nov. 30 package of stories on pharmacists [“RX: Take With Advice”] was very informative, but you and the pharmacists omitted two very important suggestions for readers:
Carry a printed list of all your prescription and nonprescription drugs in your wallet or purse. Include name of drug and your dosage and frequency. I also have the list (mine and my wife’s) as a memo on my BlackBerry.
When you get a new prescription, read the literature that the pharmacy prints out and gives you.
Arnold Daitch
Northridge
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My grandfather was a pharmacist who used to compound some of his own medicines. My mother was a clinical pharmacist much like the articles describe, just superb at her job. They taught me to ask questions -- because the pharmacist knows better than anyone.
Josh Thomas
Kentland, Ind.
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The comments made in the article about generic drugs are generally true. However, a generic version of a brand-name drug that contains the same amount of active ingredient does not necessarily make it pharmacologically equivalent to the brand-name product.
You may recall some time ago the flurry caused by the erratic effect of some time-released psychotherapeutic products. It seems that the release schedule of the active drug in the generic versions was not the same or as predictable as that of the brand names, causing considerable anxiety among some patients.
There is stuff in most drug dosage forms other than the therapeutic agent, especially in tablets and capsules and, in particular, time-released versions. There are binders, exploders, flavoring agents and coatings, all of which may contribute to the total pharmacological effect. Changing those ancillary ingredients, or their ratio or quality, can have pronounced and often unpredictable results.
Although the vast majority of generics are therapeutically equivalent to brand names, it is not an absolute given. Patients and providers should be cognizant of this.
Hal Sriro, graduate pharmacist, retired
Santa Monica
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My father was in the pharmaceutical and health business his whole career, so [I know] a lot of the basic suggestions and reminders in your article. But I have found a lot of people, intelligent and educated people, even, need to be reminded how important it is to follow their prescriptions through carefully.
However, I was disheartened by one main thing and that was the never-ending praise for the almost-near-perfection of generic medications, when right in the very same issue you featured a letter in which a person said their insurance abruptly switched his wife to a generic antidepressant that, within a week, had her on the brink of suicide. He paid out of pocket for the original brand-name medication she had been taking, and she quickly returned to a healthy state of mind and balance.
Not all generic drugs are created equal. I, several members of my family and friends of mine have run into this same problem with generics, and it really needs to be addressed. For the most part a great handful of generics that are either being manufactured by the brand company or have gone through proper enough trials and adjustments don’t seem to be a problem for most people. But it does happen every day, and the article seemed very pro-generic, which I’m sorry, I thought, was just not right.
Miki Kearns
Ventura County
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Pharmacy is definitely not a count-and-pour job. Pharmacists take continuing education classes as long as they are in active practice and are morally and legally obligated to consult with patients on the medications that the patient takes (prescription and over the counter), how the patient’s lifestyle affects the disease state and how the patient can achieve the best possible outcome for his or her disease state. This is what is mandated by California pharmacy law and by the Code of Ethics of the American Pharmaceutical Assn.
Thank you for a great Health section and for the focus on pharmacists.
Patricia Baker, RPh
Laguna Hills
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Americans live such hectic lives that people don’t have time to read important information about medicine and can easily miss a dose of medicine. What people don’t realize is that counseling can reduce adverse drug side effects, increase the effectiveness of medication and reduce spending on extra medication.
Denise Jen
Brea
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Pharmacists offer counseling when prescriptions are received? I, for one, had no idea this was true. If more counseling is actually offered, and people realize it exists, then pharmacists would get the credit they deserve.
Zeena Khalfan
San Diego
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Although I am a pre-medical student who understands that physicians may not like losing their clientele base to pharmacists, I recognize that pharmacists can provide the expertise physicians lack and can provide better and sometimes cheaper healthcare in a system where physicians are rushed or not available.
If clients do not want to gather information from pharmacists because they feel embarrassed or are in a hurry, it does not matter how skilled a pharmacist is compared with others. Clients need to feel motivated to actively stay with their pharmacists for counseling, rather than treat it like a chore.
Neesha Mody
Berkeley
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Erroneous medication use is a top reason for readmittance, an expensive and preventable event that makes neither the patient nor the hospital happy. As medication experts, pharmacists have the ability to reduce these numbers as well the amount of money that patients shell out in the name of newer medicines that may not necessarily be more cost-effective.
The government needs to broaden its horizon and increase focus on how pharmacists, as well as other providers, can help reduce healthcare costs.
Kelly Vitzthum
Berkeley
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I am currently completing a second-year residency at the VA in Madison, Wis., and after I’ve completed this residency, I will be a clinical pharmacist with a specialty in psychiatry.
At our VA, we have clinical pharmacists involved in multiple specialties, and pharmacy involvement is continuing to grow. It is great that the word is getting out about all that pharmacy has to offer.
Julie McNeil, Pharm.D.
Madison, Wis.
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Great Article!
However, mail-order pharmacies complicate the scenario.
Jack Casey
Mar Vista
Overeaters Anon isn’t a diet club
I was very disappointed by your unbalanced portrayal of Overeaters Anonymous in your Nov. 23 article “Eating Away.”
I have been a member for more than 15 years and have been maintaining a weight loss of 75 pounds for the last five.
Interviewing those who found it didn’t work -- or who just saw it as another diet option -- doesn’t really express to the public that OA is not a diet club but a way of life and recovery for thousands of people all over the world.
Information on the local chapters can be found at www.oalaig.org and www.oasfvalley.org. The main site is www.OA.org.
Wendy B.
Los Angeles
