On the edge of the patent cliff

Worldwide sales of brand-name prescription drugs could be cut in half by 2015 as lucrative brands lose patent protection. Generics generally capture 80 percent of a brand-name’s volume within six months.

Patients are driving the trend toward generics. About 1 in 4 physicians say the patients ask for them or prefer them. And 1 in 5 physicians say they always prescribe generics if they are available.

Surprisingly, just over half of physicians believe generics are clinically equivalent to the brand names they replace. That speaks loudly to the ability of pharmaceutical companies to persuade doctors that equivalent chemical compounds are somehow not equivalent. The FDA requires generic drugs to have the same amount of the same active ingredients of the brand names they replace and to be of equivalent quality.

Some patients are just as skeptical. A Consumer Reports poll found that 22 percent believed generics were not as effective. An equal number said generics had different side effects, despite FDA assurance on its website that generics have the same risks and benefits. In addition, 16 percent said generics were not as safe as brand-name drugs.

Generic drugs saved the health-care system more than $824 billion between 2000 and 2009. The 2009 savings per day was $383 million. In fact, a poll of drug-consuming households found that nearly half of the respondents considered branded prescription drugs “luxury purchases.”

Two-thirds of consumers do not know how much their medications will cost until they show up at the pharmacy counter. People take extraordinary measures to be able to afford their medication. About 1 in 4 use potentially dangerous practices to save money, such as failing to fill a prescription, skipping doses, using expired medicine, splitting pills or sharing medicine. About the same number reduce their spending on clothing, cut back on groceries or use credit cards more often. About 15 percent postpone paying bills.