[Closed] ot: Ibuprofen

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

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

I don't work in Pharma, but do come from a Science/Chemistry background. Threads like this are what make STW a special place! Well done folks. Since in STW tradition I now need to ruin this thread, I will ask "what carton type for a red placebo NSAID?"

Thank you!

dangerous beans... a slight miswording.

Given that a generic drug needs to only be within 20% of the amount of active ingredient

implied the dosage strength, which has nothing to do with bioavailability, which is the point you were making and one that i alluded to in my first post.

I'm very familiar with lamictal, and the points made by muddy bum are very valid.

As an aside the manufacturer's of neurofen are not reinvesting those profits to support new drug discovery.

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

Yeah that's why pharmacy seems ruled by a few massive companies, I suspect.

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 am rapidly forming the opinion that healthcare in the USA is a f'in racket 🙁

It's 'cos they use those cheap, second-hand, poor quality carbon atoms in the supermarket version.

No, for crying out loud, it's a chemical formula.

No, for crying out loud, it's a chemical formula

Did you read the thread? It's a lot more than just that, so it seems 🙂