Leisure, Lifestyle & Wellness
Brand-Name Drugs Increase Cost But Not Patient Satisfaction

As presidential candidates focus more on drug prices, new data from the website Iodine shows that generics scored highest among users in three popular drug categories. ProPublica has teamed up with Iodine to add user reviews to our Prescriber Checkup tool


This story was co-published with NPR's Shots blog.


In recent days, presidential candidates and even the American Medical Association have griped about rising drug prices, pointing to brand-name blockbusters with splashy ad campaigns.

When it comes to patient satisfaction, however, there isn't much difference between brands and generics, according to data collected by the website Iodine, which is building a repository of user reviews on drugs.


ProPublica has teamed up with Iodine, which launched last year, to add data from reviews to our Prescriber Checkup tool, which allows users to see their doctors' prescribing habits in the Medicare Part D program and compare them with others in the same specialty and state. Our drug pages (take, for example, the antipsychotic Abilify) will now include consumers' user reviews, usage statistics by state and a listing of the top prescribers in the country.


"What is it actually like to take these medications?" asked Thomas Goetz, Iodine's co-founder and chief executive. "That is the nub of what we're trying to measure2026The fact that a drug is a brand drug or a generic drug, for us, is immaterial to the patient experience."


ProPublica compared the reviews of brands and generics in three drug categories: antipsychotic medications that treat schizophrenia, antidepressants, and drugs that lower cholesterol. Iodine asks people if a drug is worth it, whether it's a hassle to take and if it works well. For each category of drug, a generic scored best on each of the three questions.


Dr. Joseph Ross, an associate professor of medicine and a health policy researcher at Yale University School of Medicine, said he wasn't surprised that patient reviews of generic and brand-name medications were similar.


"Generic medications are manufactured to be equivalent in all ways (except appearances) to brand-name medications," he said in an e-mail. "Unfortunately, many patients and physicians are convinced to spend more and use the brand-name medication by marketing initiatives, including advertisements on the television or drug coupons that promise similar out-of-pocket expenses for the higher-cost brand-name medications."


Consider antidepressants. Most drugs in the class, including Prozac, Celexa and Zoloft, are now available as generics and cost under $20 for 30 pills at Costco. By comparison, the brand-name drug Pristiq, manufactured by Pfizer, has a cash price of about $283 for 30 pills. (Those with insurance pay less, but probably still more than for a generic.) Pristiq fares worse in satisfaction than many of the cheaper alternatives.


Pfizer spokesman MacKay Jimeson said that depression manifests itself differently in different people, meaning treatment effectiveness may vary, too.


"Patients should work with their doctors to determine whether to use an antidepressant and, if so, which type of medication might be best for them," he said in an e-mail. "Any treatment of depression or anxiety disorders, whether it's medication or otherwise, must be monitored carefully by a qualified health care professional."


A similar phenomenon plays out for cholesterol-lowering drugs, known as statins. Zocor and Lipitor are now available as generics and are inexpensive. The drug Crestor, made by AstraZeneca, continues to have patent protection and costs more than $230 for 30 pills at Costco. (Again, insurance discounts would lower that price.) Crestor's user satisfaction score was about the same as the generic alternatives.


AstraZeneca spokeswoman Michele Meixell said not all statins are alike. "The efficacy and safety of Crestor has been studied in more than 120 ongoing [or] completed trials and more than 67,000 patients worldwide over the past 13 years," she said in an e-mail. "Crestor is one of the two high intensity statins available and AstraZeneca believes it's a clinically important option for many patients, who are unable to reach their cholesterol goal with diet and exercise alone."


Both Pfizer and AstraZeneca noted that patients can receive discounts from the company.

Some drugs have many more Iodine reviews than others, which may affect the results. All told, Goetz said Iodine has reviews from more than 100,000 Americans covering the approximately 500 drugs in its database.


Goetz said he doesn't know why generics sometimes have higher satisfaction than brand-name drugs, but he offered one theory. "People might have outsize expectations for what a heavily marketed drug is going to do for them," he said. "They may watch the commercials and think that any given drug is going to be the answer to all their problems. And the reality of medicine and the reality of pharmacology is that every drug has some benefits for some people and some side effects for some people, and that's the whole balance."

Generics may have another advantage over newly launched drugs in the same class. By definition, a generic has been on the market a long time, so doctors know how it works, and any major problems or side effects would have already surfaced.


By comparison, the studies that help brand-name drugs win approval may not have picked up safety problems or side effects that, while uncommon, can represent an issue once a medicine is taken widely.


Questions about cost and quality are likely to intensify. This week, the AMA called for a ban on direct-to-consumer advertising of drugs and medical devices. AMA board chair-elect Patrice A. Harris cited "concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices."


Ross, the Yale researcher, said eventually the costs of brand-name medications "will catch up with us, either in the form of higher out-of-pocket payments once the coupons run out or higher health insurance premium costs."


And, he added, "just because something is more expensive in health care does not mean it works better or is safer."


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Gold deposit scheme collected only 400 grams: report
Only 400 grams have been deposited so far under the gold deposit scheme and the government has agreed to review the scheme and open more centres for gold testing and depositing in banks, says a report
The gold deposit scheme launched amid fanfare by Prime Minister Narendra Modi two weeks ago has so far attracted only 400 grams, says a report from Reuters quoting an industry official.
Quoting, Anil Sankhwal, the northern regional chairman of Gem and Jewellery Export Promotion Council (GJEPC), the reports says, a shortage of centres to assay the gold being put on deposit is a problem that the government has agreed to address.
After meeting with Finance Ministry officials, Sankhwal told reporters that only 400 grams have been deposited so far (under the gold deposit scheme) and the government has agreed to review the scheme and open more centres for gold testing and depositing in banks.
Indian households’ fascination for gold is as old as India’s history and has only grown over the years. As a result, gold jewellery has been used both as an asset and as a hedge against adverse circumstances. The household investment in physical asset had risen to 66.4% in FY12 from 49.6% in FY06, before declining to 58.7% in FY14. The households’ fascination for gold however did not diminish much. Their savings in the form of gold & silver ornaments had reached Rs37,267 crore in FY13 before declining somewhat to Rs33,427 crore in FY14.
The gold monetisation scheme is also a welcome step taken by the government to unlock the value of gold held by households or institutions and to reduce the dependence of Indian investors and gems and jewellery sector on imported gold. Also, it is an improvement over the existing gold deposit scheme 1999.



Prashant Rane

11 months ago

I want to use this scheme but even after searching on google I am not aware how practically do I deposite my gold? No information on banks , refining centers? Can anyone tell some detail practical procedures with physical address of participants.

Prakash Bhate

11 months ago

Just shows that people do not trust the Government.

Nifty is headed higher – Thursday closing report
Nifty may now target 8,000 and higher
We had mentioned that Nifty, Sensex may find short-term bottom and that Nifty may move a bit lower, but may find a bottom around 7,600. Key Indian equity indices surged on Thursday as investor mood was upbeat over some key reform-oriented decisions taken by the government. The gains in the indices at the close of trading were around 1.4%-1.5%. The day’s trends of the major indices are given in the table below:
A day after the central government announced a string of major decisions to increase public spending in the infrastructure sector and with heightened chances of key reforms getting passed during the upcoming parliament session, Indian equity markets exhibited buoyancy on Thursday, supported by strong global cues. In addition, a strengthening rupee restored investor confidence. Attractive stock prices and announcements of disinvestment and interest subvention scheme for exporters brought back investors.
On Wednesday, the Union Cabinet, headed by Prime Minister Narendra Modi, was in overdrive as it approved 27 decisions -- including some key ones such as divestment of equity in Coal India and direct subsidy for cane farmers. These decisions signalled continuation of economic reforms and closely followed an official note issued last week, in which foreign equity norms were relaxed in some 16 sectors.
The government's efforts to reach out to the opposition before the crucial winter session to get the Goods and Services Tax (GST) bill passed cheered the markets.
The federal open market committee (FOMC) minutes of the US Fed's October meeting which were released late on Wednesday lessened chances of an interest rate hike. The minutes decreased the possibility of a rate hike in December 2015, as inflation and retail sales have shown less-than-expected growth.
All these factors buoyed markets, and Wednesday’s losses were reversed. The market is bullish again. Asian indices have also recorded more than 1% gain in the day’s trading on Thursday.
The government on Thursday provided a fillip to high-tech investors. Innovators seeking government help to transform their ideas into reality can now turn to a dedicated web portal to be set up for them, a minister said. "I have decided that there will be a separate, dedicated portal of my ministry dedicated to the innovators of India," IT Minister Ravi Shankar Prasad said at the Intel DST Innovate for Digital India Challenge event in New Delhi. "Anyone can put their innovation on the portal, and my department will follow them up," Prasad said. "I will personally monitor the progress of how these ideas are being followed up."
In another favourable development for the technology industry, global IT giant Intel on Wednesday launched a centre in a Telangana village under a new initiative aimed at working with the governments of various states to create a blueprint for digitisation of rural India. The first such Digital India Unnati Kendra under the initiative "Ek Kadam Unnati Ki Aur" has come up in Nadimpalle village in Mahabubnagar district. It will be used to create the framework for the Telangana model digital village. Besides providing various citizen services under the Telangana government's e-panchayat programme, the centre will provide devices, relevant local content and training for citizens thereby creating opportunities for development and empowerment. The centre is training 800 people in the village in digital literacy. Intel is also distributing among households its product PC on a stick which converts a television into a computer. The centre is also providing content through Intel's partners. Intel has roped in Micromax, HP, Snapdeal and Shweta Computers and Peripherals as partners for the initiative. They will contribute through their content, solutions, products and services. Such a development could help in the growth of all players in the IT industry.
Consulting and enterprise solutions company TAKE Solutions Ltd on Wednesday announced that it has entered into an agreement to acquire the Bengaluru-headquartered Ecron Acunova for Rs115 crore. In a statement issued here, TAKE Solutions said Ecron Acunova was in the life sciences service space. "This association will enable TAKE add expertise in the areas of Biosimilars, Regenerative Medicine and Diagnostic imaging agents space which are emerging growth areas. This will help TAKE move the addressable market for its services to $30 billion. It will also significantly enhance presence in Europe and Nordic countries," the statement added. TAKE Solutions share price closed at Rs185.90, up 2.0%, on the BSE.
In a blow to the low-cost packaging industry, the Uttar Pradesh government may announce new policy measures. Use of polyethene across Uttar Pradesh may be banned by this year end, an official said on Thursday. The Allahabad High Court (HC) has directed the state government to ban the use of polyethene across the state by December 31. Responding to the rap by the court with regard to delay in banning polythene sheets and bags, the government informed the court that a draft proposal for this was ready. Sources said the government would promulgate an ordinance before the end of the year 2015 and ban use of polyethene across the state. Officials also informed the court that the draft proposal has been okayed by the chief secretary during a meeting on October 26 and that it would soon be presented before the cabinet. Common people have been asked to send in their feedback, objections and suggestions on the issue and once this is done the proposal will be presented before the state cabinet, an official informed IANS. A bench of Chief Justice DY Chandrachur and Justice Yashwant Verma has asked the government to implement the ban before December 31.
Also from Uttar Pradesh, there was negative news from the agricultural output front, which could affect rural demand adversely. As many as 50 of the 75 Uttar Pradesh districts have been declared drought-hit, an official said on Thursday. The revenue collections in the affected districts would remain suspended till March 31, 2016, the official added. The decision was taken by Chief Minister Akhilesh Yadav after assessing detailed district-wise report of the drought situation. Among the districts declared drought-hit are Faizabad, Jhansi, Sant Ravidasnagar, Lucknow, Allahabad, Mirzapur, Ballia and Ghaziabad. Extensive relief measures have been ordered by the chief minister and departments like irrigation, rural development, panchayati raj, agriculture, social welfare, institutional finance, animal husbandry and health have been asked to execute special schemes to mitigate the problems faced by farmers in these areas, a government official told IANS.
Two-wheeler major Hero MotoCorp on Wednesday reported 11% growth in sales during the just concluded festive season this year. The world's largest two-wheeler manufacturer reported that retail sales of over 1 million units, during the 35-day festive period, starting from the Navratras. The company credited the sales growth to healthy customer response for Maestro Edge and Duet scooter and increasing demand for new Splendor PRO motorcycle. "These, along with the robust sales of Passion PRO and Glamour bikes, and the continuing popularity of Pleasure and Maestro scooters have resulted in this double digit growth," the company was quoted in a statement. The shares of the company closed at Rs2,591.35, up 0.76% on the BSE.
Besides equities, the rupee too made gains during the day's trade. It closed Thursday's trade higher by 11 paise at 66.19 to a US dollar from its previous day's close of 66.30 to a greenback. 
The foreign institutional investors (FIIs) were net sellers in the day's trade at stock exchanges, whereas the domestic institutional investors (DIIs) were net buyers. According to data with stock exchanges, the FIIs sold stocks worth Rs.343.18 crore, while the DIIs bought stocks worth Rs.233.82 crore.
The top gainers and top losers of the indices are given in the table below:
The closing values of the major Asian indices are given in the table below:


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