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Old 09.11.2011, 12:47
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A Geneva-based rheumatologist has said he will no longer prescribe Novartis medicines to patients in protest at job losses at the pharmaceutical company, which plans to shutter its production operations in the south-west of the country.

Read the full article: Swiss doc boycotts Novartis over job cuts
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Old 09.11.2011, 14:04
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Re: Swiss doc boycotts Novartis over job cuts

Is it so difficult to write "doctor". "Doc" is used mostly by Bugs Bunny and teenagers, and probably shouldn't be used by news sites. Not even tabloids reduce themselves to that.

As a side note, when I read this I thought DOC was boycotting, which led to some understanding problems.
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Old 09.11.2011, 14:07
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Re: Swiss doc boycotts Novartis over job cuts

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Is it so difficult to write "doctor". "Doc" is used mostly by Bugs Bunny and teenagers, and probably shouldn't be used by news sites. Not even tabloids reduce themselves to that.

As a side note, when I read this I thought DOC was boycotting, which led to some understanding problems.

There is only 1 doc...

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Old 09.11.2011, 14:11
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Re: Swiss doc boycotts Novartis over job cuts

A story over one doctor? Only One?

I have a headline for you, The Local. I did a poo this morning! Surely this is important, isn't it?
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Old 09.11.2011, 14:14
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Re: Swiss doc boycotts Novartis over job cuts

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A story over one doctor? Only One?

I have a headline for you, The Local. I did a poo this morning! Surely this is important, isn't it?
That makes 2 of us
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Old 09.11.2011, 14:23
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Re: Swiss doc boycotts Novartis over job cuts

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A story over one doctor? Only One?

I have a headline for you, The Local. I did a poo this morning! Surely this is important, isn't it?
Also, he will continue to prescribe Novartis where there is no generic alternative.

Hang on a minute... that means that until now he prescribed Novartis products even if there was a cheaper generic alternative? Oh wait, this is common practice in Switzerland? Also, the government is against parallel imports for medication, which are sold much much cheaper in the EU? And consumers pay for this nice cartel through health insurance that keeps going up and up?

Now that would be worthy of attention. Unfortunately, journalistic skills and efforts beyond "copy, paste and translate" are required for this one - and The Lolcat lacks these.
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Old 09.11.2011, 14:36
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Re: Swiss doc boycotts Novartis over job cuts

Shouldn't all doctors be prescribing generics when available?
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Old 09.11.2011, 15:44
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Re: Swiss doc boycotts Novartis over job cuts

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A story over one doctor? Only One?

I have a headline for you, The Local. I did a poo this morning! Surely this is important, isn't it?
only if you poo'd to protest against Novartis / bank bailouts / gay marriages ...
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Old 09.11.2011, 15:49
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Re: Swiss doc boycotts Novartis over job cuts

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only if you poo'd to protest against Novartis / bank bailouts / gay marriages ...
Well, I did protested a bit but it was such a relief....
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Old 09.11.2011, 14:13
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Re: Swiss doc boycotts Novartis over job cuts

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There is only 1 doc...
Had a pretty big discussion yesterday with BH because of him. We were watching Fringe, and he refused to believe me when I said "It's Doc!!!!!!!".

I guess having seen the films more than 20 times might help my memory...
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Old 09.11.2011, 15:01
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Re: Swiss doc boycotts Novartis over job cuts

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Is it so difficult to write "doctor". "Doc" is used mostly by Bugs Bunny and teenagers, and probably shouldn't be used by news sites. Not even tabloids reduce themselves to that.

As a side note, when I read this I thought DOC was boycotting, which led to some understanding problems.
The use of "doc" along with typographical errors would seem to indicate the need for a copy editor of some sort.

From the article:

"The doctor said the move would affect his patients since there are many equivalent products in his field, especially generics, that he can prescribe to substitute Novartis medicines."

(Ermm, isn't the point that his boycott will NOT affect his patients, since there are med equivalents available to substitute?)

.....

"Novartis, meanwhile, said it was monitoring the situation and would try to repond to people's concerns."

(Always good to have an appropriate reponse to people's concerns.)

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Old 09.11.2011, 14:50
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Shouldn't all doctors be prescribing generics when available?
It depends. Not all generics work on all patients. Some have fillers or other substances that patients are sensitive to. Sometimes the dosages are inconsistent... This is or was a big problem in the US where many generics(often imported) used were not subjected to adequate quality control. I don't know what the situation is here. Most of my generics seem to come from sandoz, and maybe mepha.

For many medications it is just fine, but it really depends.
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Old 09.11.2011, 15:36
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Re: Swiss doc boycotts Novartis over job cuts

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It depends. Not all generics work on all patients. Some have fillers or other substances that patients are sensitive to. Sometimes the dosages are inconsistent... This is or was a big problem in the US where many generics(often imported) used were not subjected to adequate quality control. I don't know what the situation is here. Most of my generics seem to come from sandoz, and maybe mepha.

For many medications it is just fine, but it really depends.
This is really misleading information!! A generic can only be called a generic if its identical and directly substitutable with the originator product. There is no ambiguity or confusion here, a generic is an identical copy or its a different drug. Perhaps the situation you describe in the US involved an importer bringing in v.poor quality or counterfeit drugs.
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Old 09.11.2011, 16:08
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Re: Swiss doc boycotts Novartis over job cuts

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This is really misleading information!! A generic can only be called a generic if its identical and directly substitutable with the originator product. There is no ambiguity or confusion here, a generic is an identical copy or its a different drug. Perhaps the situation you describe in the US involved an importer bringing in v.poor quality or counterfeit drugs.
Well maybe in Switzerland, but this has not been the case in the US. There is ambiguity and confusion. Some imported "generics" have been shown to be of poor quality. I have a friend who is a psychiatrist and she's seen a lot of variation in efficacy in her patients taking some generics - patients essentially end up experimenting with their dosages to reach the same efficacy.

And again, I've also heard that some patients don't do well on some generics due to different fillers in the medication, but again this is in the US. So maybe it's different in Switzerland.

But of course, I don't have a scientific paper to cite here, nor am I familiar with the manufacturing process. I take several generics myself and don't have a problem with them. I've heard a lot of patients complain and I don't think it's all in their head. But again, this is US, not Swiss experience.

Are you saying that a generic drug has exactly the same composition down to the fillers? If that's the case, how can they be different colors and sizes when compared to the original.
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Old 09.11.2011, 16:53
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Re: Swiss doc boycotts Novartis over job cuts

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Are you saying that a generic drug has exactly the same composition down to the fillers? If that's the case, how can they be different colors and sizes when compared to the original.
The generic component refers to the active ingredient, how thats packaged up may change between manufacturers but they should provide pharmacokinetic data to show bioequivelence i.e. the active ingredient is distributed and taken up by the body in a similar fashion. These types of studies usually involve a clinical trial where one lot of patients are given the generic drug and the other lot the originator drug, and then there is a cross over where they change over to other. So basically the regulations are very stringent, especially in the US which is why I'm surprised by what you wrote.
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Old 09.11.2011, 17:02
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Re: Swiss doc boycotts Novartis over job cuts

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Is it so difficult to write "doctor". "Doc" is used mostly by Bugs Bunny and teenagers, and probably shouldn't be used by news sites. Not even tabloids reduce themselves to that.

As a side note, when I read this I thought DOC was boycotting, which led to some understanding problems.

maybe the local uses teenagers to write the (not so) news
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Old 09.11.2011, 18:04
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Re: Swiss doc boycotts Novartis over job cuts

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The generic component refers to the active ingredient, how thats packaged up may change between manufacturers but they should provide pharmacokinetic data to show bioequivelence i.e. the active ingredient is distributed and taken up by the body in a similar fashion. These types of studies usually involve a clinical trial where one lot of patients are given the generic drug and the other lot the originator drug, and then there is a cross over where they change over to other. So basically the regulations are very stringent, especially in the US which is why I'm surprised by what you wrote.
I'm guessing I've incensed some pharma workers. And I didn't mean to "mislead", although some patients are sensitive to certain fillers in generics. And OK, so maybe it's splitting hairs, but I'm not saying that most generics aren't good enough.

As an example there's this:
http://journals.lww.com/neurotodayon...o_Brand.3.aspx

This was dealing with epilepsy drugs - So generally speaking, in 99% of cases generics are fine, within 15% of the brand name in terms of bioequivalence.One of the points these guys bring up is that within generics, however, if you switch from generic A to generic B, it's possible to have a larger variation in bioequivalence. And then there's the issue that bioequivalence, measured in the blood, isn't applicable for all drugs (e.g., ophtalmology meds).

In the US, the requirements may be stringent for the initial approval, but the quality control of the ongoing process varies, and if you're like many patients you may have a different generic every month and that could result in some problems. Also, I was reading something about the Waxman something law - once you demonstrate bioequivalence you don't have to have intensive clinical trials (this was put in place to encourage the growth of generics).

Also, the inert portions of the drug - for example, a gluten intolerant person may have a problem with a filler made of maltodextrose.

But anyway, I'm going way OT here, and it doesn't really have much to do with Switzerland as far as I can tell - I just wanted to defend my initial statement.
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Old 09.11.2011, 23:26
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Don't get me wrong, I'm not defending generics. I've always worked for innovator drug companies and so generics are a thorn in our side however I wouldn't want to unfairly malign them with innuendo or pseudo science. The whole concept of generic medicines are that a patient can expect the same efficacy and safety from a generic product as they would the originator, and this is what the health authority assess before granting a generic compound a licence. The study you quote above is interesting, as it does show that the margin for similarity may be wide enough that a patient swapping from one to another, may lead to differences in efficacy/safety. However the study is based on modelling and simulation, as opposed to real clinical trial data. A general rule of thumb is that if a doctor places a patient on a particular drug, the patient should stay on that brand (originator or generic) and not keep changing between them.
I don't consider patient or provider experiences to be innuendo. Nevertheless, for the vast majority of patients generics are fine. In the US, if your doc writes on a script that generics are permitted, then the pharmacy will provide the generic based on what they have. I was on omeprazole for a while and the manufacturer of the capsule changed several times. Not a problem with this drug for me.
 




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