Insurers' drug-switching push prompts warning

Big Pharma may have found some unexpected allies in its battle against generic competition: consumer groups. Two advocacy organizations in Florida are warning consumers about "therapeutic switching," which goes one step beyond straight generic substitution. Insurers are urging their members to try cheaper generic forms of their meds, and sometimes this means moving not to a generic equivalent, but to a generic drug in the same class, the groups warn. For instance, a patient using Pfizer's cholesterol-fighter Lipitor might be encouraged to switch to simvastatin, a generic version of Merck's Zocor.

As you know, simvastatin and Lipitor are not necessarily created equal. In fact, many drug classes contain meds that, while therapeutically similar, work differently in different patients. Antidepressants in the SSRI class, for instance, don't work exactly the same in a particular patient, so moving from one to another can not only cause side effects, but differences in efficacy.

Consumer Federation of the Southeast and the Florida Public Interest Research Group are trying to get the word out about this type of switching, and are encouraging patients whose insurers are lobbying for a generic drug to discuss the switch with their doctors first.

"There are certain drug classes where it may be safe to switch from one drug to another, and there are others where switching can be dangerous--and the person deciding that should be the patient's physician," Dr. Bruce Rubin, assistant professor of clinical neurology at the University of Miami's Miller School of Medicine, told the Tallahassee Democrat.

- read the story in the Democrat