[Closed] ot: Ibuprofen

No.

No.

Yes.

About £1 per pack spent on marketing and advertising.

Never buy Nurofen,any supermarket or pharmacy will have a generic brand of ibuprofen which is much cheaper.
Ian

any supermarket or pharmacy will have a generic brand of ibuprofen which is much cheaper.

Possibly have smoother sweeter flavoured coatings, which make the extortionate pricing easier to swallow.

Also there's not much different between Lemsip and a value brand paracetemol.

You could drink some hot water with lemon juice in it for a full Lemsip experience.

Just compare the active ingredients list - some branded stuff will do bigger qtys of the active ingredients (usually 'max strength' type name) but not anything enough to justify the price diff.

There's me thinking, I'll be smart and go to nurofen.co.uk and prove these guys wrong by researching the actual ingredients!
Here's what I found:

[i]Ingredients:
Ibuprofen
What is it?
Ibuprofen is a NSAID (Non-Steroidal Anti-Inflammatory Drug)...etc[/i]
er, that's it!

So glad I always buy the cheap stuff now 🙂

max strength normally means caffeine.

just buy the cheap stuff, if you need to spend an extra £3 getting a stronger dose, just take more of the cheap stuff!

No difference whatsoever between a branded drug & a generic. If there is a choice, go generic everytime. In the NHS there are very few branded drugs in use, unless the drug is not available in generic form.

I always ask for generic stuff, especially kids meds, as calpol makes kids go looney, and I hate it when the made up assistant instantly turns to the smallest & least VFM calpol bottle. They usually look blank when I ask for own brand, then call the pharmacist over.

There is this difference:
[i]Nurofen Express targets pain twice as fast as
standard ibuprofen tablets.
Nurofen Express 256mg Tablets and Caplets contain sodium ibuprofen[/i]

Just compare the active ingredients list - some branded stuff will do bigger qtys of the active ingredients (usually 'max strength' type name) but not anything enough to justify the price diff.

If that was the case say they had 400mg in and not 200mg then you take 2 of the cheaper ones.

Exactly...

DezB - Member

There is this difference:
Nurofen Express targets pain twice as fast as
standard ibuprofen tablets.
Nurofen Express 256mg Tablets and Caplets contain sodium ibuprofen

Twice as fast as what?

edit : I read that too quickly, still like them to prove it though.

as calpol makes kids go looney

Whats the generic alternative to Calpol? I know its basically just paracetamol but its dosed correctly and tastes nice. I cant see my 11 month old sipping on some incipid liquid.

What should I ask for and does it taste nice?

As to Ibuprofen - if its a muscular injury I would always use a spray as opposed to tablets as you are just hitting the area needed as it reacts very quickly.

Mastiles all the infant Calpol stuff is sugar free

Whats the generic alternative to Calpol? I know its basically just paracetamol but its dosed correctly and tastes nice. I cant see my 11 month old sipping on some incipid liquid.

Liquid Paracetamol.

as you are just hitting the area needed

Not exactly true but I see your point.

I thought brufen wasn't absorbed very well topically?

Always, always check active ingredients in medicines. Painkillers especially; generic paracetemol is like two pence a gram, big name brands might be ten times that.

I just popped into our local pharmacy to get some Ibuprofen to be told that Cuprofen was generic Ibuprofen. Not at £2.16 it's not!

I know people who deliberately buy nurofen, knowing it is the same as any other ibuprofen, for the extra placebo effect the brand name brings.

There is, however, a noticeable placebo effect in taking Nurofen over the same non-branded dose of ibuprofen.

And the point is that even if you are aware that you are essentially taking the same thing, the placebo effect still gives better pain relief.

Weird, but apparently true.

(See Ben Goldacre's Bad Science)

"Liquid Paracetamol."

Cant say I have ever tasted it, but disolvable paracetamol taste like sh!te so I can't imagine liquid without any thing in it will be nice?

Bear in mind that Neurofen Plus is different since it has coedine. However this is also available (but less widely so) in a generic form for buttons.

Ibuprophen is crap at being absorbed through the skin,

For muscular pain it has a mix of a placebo effect and the massageing in of the gell is more usefull.

For injuries like ITB friction its actualy counter productive as massage to the painfull area makes them worse.

I just popped into our local pharmacy to get some Ibuprofen to be told that Cuprofen was generic Ibuprofen. Not at £2.16 it's not!

No, Cuprofen is just another brand like you say.

Try somewhere like Tesco, they do own brand ibuprofen for about 30p for a box of 16 tablets. They also do generic hayfever tablets which can save a huge amount over the cost of the branded stuff. The stuff I get is usually about 75% cheaper than the branded meds!

No difference whatsoever between a branded drug & a generic. If there is a choice, go generic everytime. In the NHS there are very few branded drugs in use, unless the drug is not available in generic form.

Bizarrely, the NHS still always use branded Gaviscon rather than the generic stuff. Not sure why but i read that it's reckoned to cost the NHS millions every year which they don't need to spend 😡

Mastiles all the infant Calpol stuff is sugar free

[url= http://www.calpol.co.uk/our-products/CALPOL-infant-suspension ]Note the picture - shows the two versions - one being clearly labelled 'SUGAR FREE' :-P[/url]

What I don't get is that some of the (I think) nurofen adverts claimed some special formula that goes straight to the pain location. On checking the ingredients list I found it was exactly the same as all the other nurofens and exactly the same as the other 28p packets. On speaking to a pharmacist the other week she said they were telling porkies as ibuprofen is system-wide and non-targetting and yes the ASDA versions are identical.

Bizarrely, the NHS still always use branded Gaviscon rather than the generic stuff. Not sure why but i read that it's reckoned to cost the NHS millions every year which they don't need to spend

My brother is a gaviscon user, he claims the generic version does not give the same results and he's not prone to being taken in by marketing. I wonder if there's differences in the available amounts of active ingredient?

Coffeeking - I had a rant about that myself recently - glad my assumption was correct 🙂

Whats the generic alternative to Calpol

Asda certainly do their own paracetamol suspension which tastes enough like the 'real' calpol for Mini Clubber not to complain.

My brother is a gaviscon user, he claims the generic version does not give the same results and he's not prone to being taken in by marketing. I wonder if there's differences in the available amounts of active ingredient?

Placebo effect works even if you "know" it's just marketing.
It's not just the weak-minded who are affected by this, it's everyone.

Strange but true.

[url= http://www.manchesterwired.co.uk/news.php/132638-NHS-sues-Gaviscon-maker-Reckitt-Benckiser ]NHS and Gaviscon is not as simple as buying it from someone else.[/url]

Hang on.

If I know that Nurofen is the same as generic Ibuprofen, and I am convinced beyond doubt of this fact. Then surely any placebo effect is not possible, or at least I would recieve the same placebo effect from taking the generic as I know it is the same, along with an added smugness factor cos I saved 40p per tab.

A placebo can surely only be in effect if you percieve there to be a difference between the tabs.

Agreed stuey

NHS and Gaviscon is not as simple as buying it from someone else.

Thanks for that, it makes interesting reading!

Would anyone like a proper reply?

As a formulator for one of the biggest generic firms in the UK (I left just as they were bought out by an isreali company) the active ingredient is the same, for a given value of same.

I.e. chemically they will both be ideally be >99.5% pure (when in liberated form), a different manufacturing process can give you a different impurity profile and stability of the end product.

The main difference is to do with the physical properties which can and does effect the chemical properties to an extent.

Particle size, shape and form were the main ones we found - we would spend of attention to this and less to the excipients (obviously modified release agents effect this too). Many older cheaper forumaltions will use steric acid in the tablet formulation to lubricate equipment which can prematurely soften tablets, newer ones replace it with magnesium sterate.

Most of the faster acting products are freeze dried or a more soluble salt - however these products are generally less stable. So instead of a 5 year shelf life it will have a 2 year shelf life (for example). A lot of these are used either a patent extentions or a new "grab" to get market share over generics.

Kinda digressing here, but essentially - yes the chemical is pretty much the same, but no - the rate of effect and amount of effect is not always the same (although rate of release from the tablet should be comparable between like for like).

A placebo can surely only be in effect if you percieve there to be a difference between the tabs.

Placebo/Nocebo effects do not operate at the conscious level of awareness but at the subconscious decison making level.

Factors such as the colour of the packaging, size of tablet etc all have an effect, and even individuals who believe themselves to be above 'brand influence' are susceptible.

Particularly relevant to pain relief - there is no such thing a 'pain' from a purely scientific pov, just the sensation of pain which is the product of the sufferers own neourological processing and not an extrinsic factor.

[i]Placebo effect works even if you "know" it's just marketing.
It's not just the weak-minded who are affected by this, it's everyone.[/i]

That's surely like saying, if the shop had filled a Gaviscon bottle with milk and I knew it was milk, it would still work better than generic heartburn medicine!

Would anyone like a proper reply?

Assuming that's true, and I've no reason to doubt you, I'm still unconvinced that these advantages merit a 1000% price hike. I think I'll stick to paying 12p for a box of ASDA paracetemol.

and even individuals who believe themselves to be above 'brand influence' are susceptible

Not TJ tho 🙂

Saccades - I did suspect that would be the case. Afte all the 'ingredients' are simply legally bound to tell you the active ingredients, and it seems to me there's more to pill making than simply sticking a chemical in some sugar. And they wouldn't be able to stick 'faster acting' etc all over the box if it wasn't at least partly grounded in reality.

Agreed though that the price hike is large!

Factors such as the colour of the packaging, size of tablet etc all have an effect, and even individuals who believe themselves to be above 'brand influence' are susceptible.

I'll bet TJ is not susceptible.

EDIT - Dammit! beaten to it!

So who would rather ride a 'generic bike' rather than a 'premium brand bike' - both have the same list of ingredients (components) don't they ??

poor analogy - the active ingredient in the generic/branded drugs is identical so your comparison would only work if say you were comparing two bikes that had exactly the same components (eg all XT) but one was painted with a flash beautiful paintjob with matching components and the other plain grey with plain coloured (but otherwise identical) components. Though you'd also have to say that the nicely painted one costs about 100x more - so let's say £300k 🙂

A company I worked for were specialists in semi-conductor X-ray
metrology, we tried diversifying into powder X-ray diffraction and to selling into the pharmocology sector.

One of the tests that were carried out was to check for optical-isomers of the active ingredients as the same moecule would have different actions on the body depending on whether it was a left-handed or right-handed molecule.

There was a paper flying around showing the ineffectivness of a generic drug that was poor compared to the original drug as "handedness" of the drug had changed (my memory says the pressing plant was to blame, but cannot be sure).

I doubt many of these ineffective isomers get into the wild and that I will keep on buying the cheapo own brands!

The problem TJ would have is working out which one gives him the best perceived value for money - he would get a headache just trying to work it out.

poor analogy

I dunno. Imagine a flash looking bike with XT on it that had a clunky high tensile steel frame.. Although it'd get you around basically the same, it woudln't be as good as a 456 would it? And yet to the casual observer...

Remember British Eagle?

Still not a proper analogy. Generics have identical active ingredients and less marketing (eg flash paintjob), not more.

That ibuprofen does go straight to the point of the pain, It just goes everywhere else at the same time,

One of the tests that were carried out was to check for optical-isomers of the active ingredients as the same moecule would have different actions on the body depending on whether it was a left-handed or right-handed molecule.

Thalidomide was one such case was it not? Not that a cheapo version had problems but that all versions had varying amounts of the two that were indistinguishable chemically.

However since, I think, generally the generic products are made the same way as the patented ones (just after the patent ends) the chemicals should be identical.

That ibuprofen does go straight to the point of the pain, It just goes everywhere else at the same time,

And that's probably their take on it too!

Interesting and not unexpected Saccades but the difference on the effect on the body is probably so minimal it'll make no noticeable difference.

There is still a subtle difference tho clubber that most people will miss amid the hype/marketing/cynicism.

along with what Saccades has said, another important thing factored into the big brands pricing structure is the amount of money spent on R&D for not only these drugs, but everything they are currently testing and developing. basically the cheapo supermarket brands do not have any of these costs, they just copy the compounds and knock the pills out to the punters.

i work relatively closely to the pharma industry and generally buy the branded stuff as i know part of my money is going towards developing new drugs.

but everything they are currently testing and developing.

Like nurofen yellow, nurofen red, nurofen microseconds faster acting, nurofen with slightly different combinations of existing drugs that might work slightly differently in different people.

At 10x the price. No thanks.

But the simple painkillers aren't what big pharma is researching: the OTC drugs are nearly all old ones and aren't marketed by big pahrma or in the same way.

Saccades hasn't mentioned release modifications, where the formulation (ie how you grind up the active ingredient, what you mix it with) is designed to either deliver quickly or keep releasing the drug slowly.

Incidentally, ibuprofen was invented by a Boots scientist in Nottingham when they still did proper research. Once they were merged with an international company, all that stopped 🙁

I was only answering the OP, the price difference is a seperate issue.

is there any difference between Nurofen 200mg and Asda own brand 200mg, apart from the huge price difference?

If the magnitude of the difference was marked, the generic would never be approved, but there are small differences.

Thalidomide was indeed the most famous case of chirality, off the top of my head the clinical trail batches used were manufactured in a pilot plant which produced predominently Dexo (~98% right handed) form, but when the main manufacturing started the plant produced ~37% levo form causing the defects.

I know that a large pharma manufaturer has to give half their freeze dried pain killers a shorter shelf life because 2 of the 4 freeze driers are older and cannot freeze dry as quick producing a less stable crystal form.

There are many tests for chirality, obviously plane polarised light being the easiest - I was running a chiral hplc 2 weeks ago, although hplc method development is a bit empirical still. Thalidomide was a wake up call for the pharma industry that hadn't really bothered about chirality before.

But the simple painkillers aren't what big pharma is researching

exactly! they do all this marketing guff because it's a good way to keep hold of a sizable market share (keep the majority of non-STW-aware punters thinking that nurofen is the bees knees), thus bringing in lots of money to pile into (for example) new cancer treatment drugs etc.

Top interesting thread this from a fairly inane whinge to start with - good stuff STW 🙂

exactly! they do all this marketing guff because it's a good way to keep hold of a sizable market share (keep the majority of non-STW-aware punters thinking that nurofen is the bees knees), thus bringing in lots of money to pile into (for example) new cancer treatment drugs etc.

So if maintaining a high price on nurofen is paying to find the cure for cancer, why is it that all of the cancer drugs also cost stupendous amounts? You can't claim to be the do-gooder at both ends. R&D is the primary cost of most important drugs as far as I'm aware, so if they're using the normal drugs to raise the R&D cash, why do they need to charge vast quantities when the tablets are finally produced?

And why do they have such vast profit margins too?

Saccades. I also work in the medicine industry. As in other industries the retailer own label is often produced by the very same company that is producing the branded version. Nurofen is owned by Reckitts, Reckitts are in the top 5 advertising media buyers in the world. Advertising is paid for out of the profit they make on the product. I buy Tescos ibuprofen.....there is no difference.

So if maintaining a high price on nurofen is paying to find the cure for cancer, why is it that all of the cancer drugs also cost stupendous amounts?

Cos it's expensive.

First rule of retail CK - you charge what people will pay. So if people are prepared to pay £2 for 12 Neurofen then it'd be silly of the manuf not to charge it. The extra money you can re-invest, pay to shareholders or roll around in giggling and throwing it up in the air.

And why do they have such vast profit margins too?

Profit can be re-invested, no?

EDIT: It appears to be argue with CK day today in the land of Grips. Sorry about this 🙂

I know my more expensive bike goes [i]faster[/i] and is more [i]active[/i]!

generics can't get a licence without demonstrating "essential similarity" to the original licensed product as they're effectively piggybacking onto that original licence.

This involves equivalence in terms of chemistry and also in bioavailability of the active drug (how much, how fast etc). There's a little bit of leeway in terms of differences in formulation (as someone up there said) as long as you can show you're effectively the same as the original.

It's well known that red analgesics work best - unlike red bikes which are slow and ridden by ungainly chubbers

I seem to remember that thalidomide isomers are interconverted in vivo anyway so I doubt even pure "safe" is, err, safe - or is it ?

Has thalidomide not turned out to be some kind of amazing wonder drug for something or other when you're not giving it to pregnant women?

molgrips - myeloma (& maybe some other cancers but less established) also some weird stuff like behcets and some leprosy bollocks

roll around in giggling and throwing it up in the air

clubber - Member
poor analogy

well it was slightly 'tongue-in-cheek'
But hows about generic steel Taiwanese clunker sold with unfashionable badge Vs gsTc with 'forums favourite shedman' badge 😈

Another factor in Brand Name Vs Generics (drugs) is the prevalence of either outright 'fakes' or reboxed date expired product.
The high cost of Brand Name Drugs makes it a tempting target for illicit trade...

Don't know what effect generic versus brand name has in other areas but there is a body of evidence that the changes do effect people with epilepsy quite substantially.

Given that a generic drug needs to only be within 20% of the amount of active ingredient it is possible that from one prescription to the next with 2 different generic brands you could have a potential differnce of 40% active ingredient.

For conditions such as epilepsy (and possibly psychoses) the breakthrough levels may be so sensitive that a very marked difference will be seen.

[i]Labiner DM et al. Generic antiepileptic drugs and associated medical resource utilization in the United States. Neurology 2010 Apr 14[/i]

For other drugs the effect may be very minor or not at all BUT not in all cases.

why is it that all of the cancer drugs also cost stupendous amounts?

Probably because as well as paying for that particular drug, you're also paying for the development of the 10 they had to throw away.

dangerousbeans - Member
Given that a generic drug needs to only be within 20% of the amount of active ingredient it is possible that from one prescription to the next with 2 different generic brands you could have a potential differnce of 40% active ingredient.

where does this figure come from ??

I didn't think people really took any of this sort of hokey rubbish.

But then I don't [i]do[/i] headaches.

Given that a generic drug needs to only be within 20% of the amount of active ingredient it is possible that from one prescription to the next with 2 different generic brands you could have a potential differnce of 40% active ingredient.

Bollocks - no generic manufacturer is that crap at tablet manufacture(at least any that want to sell in USA, EU or japan, which is where all the money is), general specs are 99%-98% of stated dose on release, and down to 95% at end of shelf life (but you had better have very good data to back up the degradation).

I think you might be confusing products - MDPI have a wider spec (5%) due to the trouble in filling at speed such small amounts but no OTC will be that bad. Some other odd methods of dosage delivery also have high spec's but that is not the norm.

alfagtv1969 - Member
Saccades. I also work in the medicine industry. As in other industries the retailer own label is often produced by the very same company that is producing the branded version. Nurofen is owned by Reckitts, Reckitts are in the top 5 advertising media buyers in the world. Advertising is paid for out of the profit they make on the product. I buy Tescos ibuprofen.....there is no difference.

I'll be honest I say I have knowledge of Reckitts, I'm inferring from your post that you know for certain that tesco ibruprofen and Nurofen are made in the same factory. In fact after a quick google, Reckitts are in reality a generic/bathroom products firm so that wouldn't surprise me in the slighest, I thought Nurofen was made by GSK (which I know also make bathroom products but are a proper pharma company too). It would be rare that a proper pharma company would resell it's products because their cost of manufacture is much higher than a generic firm and once a product comes off patent the value plummets as generic firms get in on the act (with the pharma firm trying to maintain profits by using the brand name). Reckitts have built Nurofen up as a brand name quite nicely, clever.

BTW - All sales teams know how to party, it's a culture of work hard, party hard. Because if you don't work hard to earn no money and your out of a job. My wife works for a cleaning firm as the office manager for a load of salesmen and we have won loads of holidays and stuff which were there as incentives.

That's surely like saying, if the shop had filled a Gaviscon bottle with milk and I knew it was milk, it would still work better than generic heartburn medicine!

I'm sure it's been said before but I'd thoroughly recommend Bad Science by Ben Goldacre.
It shows (amongst other things) the astonishing facts about the placebo/nocebo effects.

The findings are almost as unbelievable as the Gaviscon milk bottle idea.

We're pretty weirdly-wired creatures, us hoomans.

Cos it's expensive.

First rule of retail CK - you charge what people will pay. So if people are prepared to pay £2 for 12 Neurofen then it'd be silly of the manuf not to charge it

Oh sure, but say it costs £2.50 per pack of tablet A and they sell 100m of them a year, thats 250m quid. Now they're using that to develop all number of things at massive cost, and when it's finally produced etc they sell drug B (cancercurofen) at a cost of say - £5K a year per person to the NHS. Now that makes a huge difference to the likelyhood of that drug getting approved for use in individual locations, but if they were to spread the cost of that 5K a year per person (say what, I dont know, 100,000 people a year on that particular drug for a rarer problem?) that would be 5m quid spread over 100m packs, which would be 5p per pack and would make sod all difference to the headache tablet buyer but make the price of cancer drugs far more reachable for all.

Obviously my numbers are squiffy as I dont have actual figures, but they demonstrate the point - to be claiming it costs lots but then maintaining the price at both ends is a bit daft.

I will bow to your superior knowledge Saccades but this is what i was told by a respected epilepsy specialist.

I'll also admit that the study claiming my quoted figures was sponsored by GlaxoSmithKline who make Lamactil.

A quick Google on bioequivalence comes up with 'Remington: the science and practice of pharmacy' textbook which discusses a plus or minus 20% rate of absorbtion being the maximums for bioequivalence for a drug, and that a plus/minus 20% difference in blood concentration of the active ingredient is unlikely to be clinically significant.

It does seem to have a clinical significance as regards epilepsies as I have anecdotally observed on many occasions in my practice. Also NICE do seem to take this issue seriously: Clinical Guidance for Epilepsies Section 1.8.8 says:

[i]'1.8.8 Changing the formulation or brand of AED is not recommended because different preparations may vary in bioavailability or have different pharmacokinetic profiles and, thus, increased potential for reduced effect or excessive side effects'.[/i]

Whatever the true figures I try to ensure that my patients get a consistant brand of AED. Changes do seem to make big differences to seizures thresholds and most of the GP's in our area are happy to prescribe by brand rather than drug type.

Epilepsy drugs have a very narrow therapeutic range and the bioavailability can be changed by different formulations of the same active ingredient so it is always better to stay on the same tablets.
However that doesn't mean that patients cannot be stabilised on the generic equivalents, just that the regime may need to be changed to account for different absorbtion profiles.

This is not a problem with Ibuprofen.

And why do they have such vast profit margins too?

You mean massive PROFIT

The margin as a %age is tiny.
Think about all those daily wail stories about "my mum was denied this life saving drug that costs £20,000 for 6 weeks increaced life expectancy"

Now say there are 10 'mums' in the country every year, and say 500 in the world living in countries able to potentialy afford the drug. That's ~£100,000,000 'profit' you could make. Factor in a £100,000,000 development costs and its not great, factor in that you had to develop 100 other drugs that didnt make it to the market and you need to be very brave get into the pharma industry.

A quick Google on bioequivalence comes up with 'Remington: the science and practice of pharmacy' textbook which discusses a plus or minus 20% rate of absorbtion being the maximums for bioequivalence for a drug, and that a plus/minus 20% difference in blood concentration of the active ingredient is unlikely to be clinically significant.

I'd be astonished if they allowed even 5% divergence from stated drug content - still, it's blood levels that matter (or at least are a surrogate for what matters)

I don't like industry-sponsored trial much, nor do I really like case-control or whatever this epilepsy thing is (interrogating massive databases? I can't access it)

Might use of generics in the USA, where generics barely exist as a proportion of the market, imply cheaper health insurance and therefore possibly greater poverty and might this make a difference somehow, for example ?

I'm sure I've seen papers (again, metanalyses or something IIRC 🙄 ) in support of generics for cardiovascular drugs