Ross
Well-known member
If RCB were still coming around, I believe he's been on it longer than that! Yeap, 45 years.
http://www.valvereplacement.com/forums/showthread.php?t=13403
Forced to change - Coumadin to Generic
- Thread starter njean
- Start date
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If RCB were still coming around, I believe he's been on it longer than that! Yeap, 45 years.
http://www.valvereplacement.com/forums/showthread.php?t=13403
ALCapshaw2
Well-known member
VR.com has seen MANY rounds of the Brand Name Coumadin vs. Generic debate.
I will repeat some of the findings from those debates as I recall them.
The Brand Name COUMADIN has changed hands (i.e. manufacturers) at least 2, maybe 3, times as it was SOLD from manufacturer to manufacturer.
For YEARS, Coumadin Sales Representatives were telling Doctors that their medication was more tightly controlled and better than generics, yada yada yada. These 'opinions' still exist in the minds of many Doctors and patients.
There was a LAWSUIT and the then manufacturer of Brand Name Coumadin LOST. It was determined that at least one of the generic manufacturers actually had tighter tolerance control than the Brand Name. I'm thinking the other generic manufacturers tested were also within specification requirements (anybody remember the details?).
Personally, I have had NO PROBLEM with the 3 suppliers I have used: Brand Name Coumadin, Warfarin from TARO in Israel, and Warfarin from BARR in the USA.
MY Opinion is that variation is more likely the result of the AntiCoagulation Manager than the Product. Some patients (and Doctors) still claim / believe there is a difference. I expect this 'debate' will never end as long as Coumadin / Warfarin is the primary means of providing anticoagulation therapy.
Another REAL ISSUE has been Counterfeit Drugs but it seems unlikely that anyone would want to counterfeit such an inexpensive drug as Warfarin. Most of these cases have been with expensive drugs, especially Cancer related drugs and maybe some Heart drugs.
I will repeat some of the findings from those debates as I recall them.
The Brand Name COUMADIN has changed hands (i.e. manufacturers) at least 2, maybe 3, times as it was SOLD from manufacturer to manufacturer.
For YEARS, Coumadin Sales Representatives were telling Doctors that their medication was more tightly controlled and better than generics, yada yada yada. These 'opinions' still exist in the minds of many Doctors and patients.
There was a LAWSUIT and the then manufacturer of Brand Name Coumadin LOST. It was determined that at least one of the generic manufacturers actually had tighter tolerance control than the Brand Name. I'm thinking the other generic manufacturers tested were also within specification requirements (anybody remember the details?).
Personally, I have had NO PROBLEM with the 3 suppliers I have used: Brand Name Coumadin, Warfarin from TARO in Israel, and Warfarin from BARR in the USA.
MY Opinion is that variation is more likely the result of the AntiCoagulation Manager than the Product. Some patients (and Doctors) still claim / believe there is a difference. I expect this 'debate' will never end as long as Coumadin / Warfarin is the primary means of providing anticoagulation therapy.
Another REAL ISSUE has been Counterfeit Drugs but it seems unlikely that anyone would want to counterfeit such an inexpensive drug as Warfarin. Most of these cases have been with expensive drugs, especially Cancer related drugs and maybe some Heart drugs.
csutherland
Well-known member
Jerry has been on warfarin 99% of the time since his surgery in 2002. The reason for being on brand-name Coumadin at all was that it was free samples if I remember correctly & there was no difference in INR. I have no idea who manufactures the warfarin. I absolutely hated dealing with trying to split the little round Coumadin boogers. The oval warfarin breaks easily; not necessarily cleanly, but it averages out through the week's dosage.
Jerry only has problems with INR when he's been off the stuff for procedures etc.
Jerry only has problems with INR when he's been off the stuff for procedures etc.
Well, it appears that my cardio was able to convince the insurance company to fill my Rx w/coumadin & NOT the generic afterall.
When I called my cardio yesterday & told him that a rep from my insurance company would probably be calling him to see if he approved the generic instead of brand coumadin, he asked me if I wanted him to "put on the gloves" (boxing gloves?). I just told him I was sick of fighting them & for him to just go ahead & approve the generic but that's when he told me that I would have a harder time controlling my INR.
Long story short, I received notification that my prescription had been filled w/coumadin & my co-pay was $104.15 for 10mg for 90-days & $93.27 for 7.5mg for 90-days. (I have to take 7.5 mg about twice a week to stay within 3.0-4.0) If they had sent the generic, my co-pay would have been $30!
So I believe I will be getting the coumadin in the next few days!
Thanks again for your input. As always, you all are GRRRRGREAT!!!!!
When I called my cardio yesterday & told him that a rep from my insurance company would probably be calling him to see if he approved the generic instead of brand coumadin, he asked me if I wanted him to "put on the gloves" (boxing gloves?). I just told him I was sick of fighting them & for him to just go ahead & approve the generic but that's when he told me that I would have a harder time controlling my INR.
Long story short, I received notification that my prescription had been filled w/coumadin & my co-pay was $104.15 for 10mg for 90-days & $93.27 for 7.5mg for 90-days. (I have to take 7.5 mg about twice a week to stay within 3.0-4.0) If they had sent the generic, my co-pay would have been $30!
So I believe I will be getting the coumadin in the next few days!
Thanks again for your input. As always, you all are GRRRRGREAT!!!!!
Ross
Well-known member
As you wish, but it's no different, just pay more.
Side note: I bought a great pill splitter at the dollar store ($1).
ALCapshaw2
Well-known member
Did your Doctor cite any STUDIES to substantiate his claim?
(I didn't think so)
Next time you see him, ASK if he can cite any relevant research studies.
I'd be willing to bet his claim that it would be harder to maintain a stable INR on Warfarin is something that was drilled into his head by a BrandName Coumadin Sales Representative.
Actually, the generic at many stores would have been $10/90 tablets. That's what I pay at Kroger's and Walmart.
csutherland
Well-known member
A few months ago I slipped up and failed to get Jerry's warfarin refill called in with a long holiday weekend coming up. (We use a pharmacy that closes on Sat at noon thru Mon morning). I was able to get a 1-month supply called in to Dillons (Kroger). Since they didn't have his Medicare prescription Part D info on file and I didn't have his card with me I just paid full price--all of $6.00! A notation on the bottom of the slip says "By selecting the generic, you saved $51.29).
Good enough for me!
Good enough for me!
When I was still in the hospital and having problems with stabilizing my INR, I mentioned that my body does not react well with generics! The head doctor of the ICU unit said that both Warfarin and Coumadin are manufactured by the same company!!
I had to accept his comment.
AgilityDog
Well-known member
Yup, i've switched to generic in the last 6 months, and I'm no more or less stable than before. I find my diet, exercise, and water weight gain have more effect on my INR than switching to generic.
But, I now spend $10 for a 90 day supply of each dosage at the local pharmacy, which is even less than the mail order of $30 for generic and $90 for mail order name brand.
My cardio thinks there's a difference too. He cites there can be a 20% effectiveness difference between generics and name brand. BUT my pharmacy says they always notify patients if they change brands of generics of any drugs, so patients can watch for any changes in effect. So, if I'm using the same generic brand all the time, it makes no difference to me if I take 25 mg per week or 27 mg per week--whatever it takes to stay in range is fine.
My cardio gave in. I like men who can be trained like that.
But, I now spend $10 for a 90 day supply of each dosage at the local pharmacy, which is even less than the mail order of $30 for generic and $90 for mail order name brand.
My cardio thinks there's a difference too. He cites there can be a 20% effectiveness difference between generics and name brand. BUT my pharmacy says they always notify patients if they change brands of generics of any drugs, so patients can watch for any changes in effect. So, if I'm using the same generic brand all the time, it makes no difference to me if I take 25 mg per week or 27 mg per week--whatever it takes to stay in range is fine.
My cardio gave in. I like men who can be trained like that.
How do you define stable? Are you pretty much in range, or yo-yo drastically under and over range?
Yesterday, I reviewed my INRs for the last 5-6 months and I was out of range only once, with a 4.5. Otherwise, my INRs have been 2.5 to 3.5, usually hovering right around 3.0. I've been taking 5mg X 3 + 5.5 X 4 (37mg weekly). They're never the same from test to test.
My INRs seem to be more in range since I got my INRatio. But I don't know if that's just a coincidence or just me (probably the latter).
hensylee
Well-known member
I believe those of you in Medicare Part D will find that your insurance companies often try to get you to switch to generics. I have Humana and they send me literature trying to get me to switch to even another drug instead of the one rxed by the dr - telling me to ask my dr to change to the one they suggest.
AgilityDog
Well-known member
I get a bit out of range (over 4, or under 2.5) once every 2 months or so. For me that's fairly stable. I've never been the 3.0 patient, and I'm not going to claim my diet is always stable.
My dose is generally 25.5 mg per week. But earlier this summer when I was having problems with water weight, it got up to 29 mg per week. I guess if dehydration raises my INR, then excess fluid could dilute enough to lower my INR.
I'm saying I see no difference on my history chart in how often I'm out of range, between the 18 months I used Coumadin vs. the 6 months I've used Warfarin.
When I do get out of range, I generally know what has changed in the last week--stress, illness, binging on brussels sprouts, or skipping my veggies once too often. It isn't that I've changed my meds that week.
Lately, in an effort to cut salt, I've cut back on the preprocessed soy products, which means my vitamin K intake went down over all. I'm adding in sodium free tofu, instead, but some weeks I forget to buy it (or husband does the shopping), or I use real meat in my lunches, instead. I know that means my INR may be on the higher end of range that week.
When I get out of range, I just make tiny tweaks of 1 mg at a time (I'm pretty sensitive to warfarin/coumadin) and dose the diet, not diet the dose.
My dose is generally 25.5 mg per week. But earlier this summer when I was having problems with water weight, it got up to 29 mg per week. I guess if dehydration raises my INR, then excess fluid could dilute enough to lower my INR.
I'm saying I see no difference on my history chart in how often I'm out of range, between the 18 months I used Coumadin vs. the 6 months I've used Warfarin.
When I do get out of range, I generally know what has changed in the last week--stress, illness, binging on brussels sprouts, or skipping my veggies once too often. It isn't that I've changed my meds that week.
Lately, in an effort to cut salt, I've cut back on the preprocessed soy products, which means my vitamin K intake went down over all. I'm adding in sodium free tofu, instead, but some weeks I forget to buy it (or husband does the shopping), or I use real meat in my lunches, instead. I know that means my INR may be on the higher end of range that week.
When I get out of range, I just make tiny tweaks of 1 mg at a time (I'm pretty sensitive to warfarin/coumadin) and dose the diet, not diet the dose.
