Dual branding of drugs by the industry is confusing and should be stopped

For personal use only. Not to be reproduced without permission of the editor
([email protected])
Dual branding of drugs by the industryis confusing and should be stopped By Stein Lyftingsmo, a hospital pharmacist from Elverum, Norway, who has a special interest in packaging and medicines information
Before the medicine was withdrawn from dosage of bupropion:Zyban and Wellbutrin cer,in preventing Alzheimer’s disease and in
the treatment of HIV. MSD chose to use one Brand splitting may increase total sale. But brand name for chronic pain, and another for the market in Norway:Vioxx and Vioxx AC.
each brand will have reduced turnover. Low- acute pain. So it is not difficult to imagine an- The tablets had the same active ingredient, turnover packages are not kept in pharmacy and the same shape, colour and excipients.
stock, and the patient may have to wait hours Now look at an older substance: atenolol.
The brands had different information.Vioxx — even days in rural areas — for his or her was for arthritis and chronic pain, and Vioxx treatment. Brand splitting may give simpler atenolol; the Norwegian medicine authori- ties, another three.There is good evidence for the use of atenolol for another five indica- Generally, brand
tions — altogether 11 different uses for one active substance. Imagine 11 brands, each building is the
packaged with information for only one in- opposite of
For patient packs the information in drug catalogues and package inserts usually comes from the manufacturing company. There are medicine;
several examples of manufacturers claiming building double
copyright on patient information. In the US bulk, the PILs mostly comes from companies specialising in providing information.
certainly is
Different patient groups need different in- Do we have one different brand for each in- dication or information that covers all the physicians and pharmacists do not realise or minds, to the extent that some patients will different uses? Each solution has its advan- tages and drawbacks. It is important that a There is another substance that is old, but risk analysis is made, since different substances to generic competition between companies.
interesting in this connection: thalidomide.
But to most people it is unexpected and il- Leprosy is the only indication approved by Is it possible to differentiate information logical that a company should appear to com- in generic packages? Perhaps there should be two setss of PILs. Maybe there could be sep- Doctors are confused. I know this because main uses of thalidomide are off-label for tu- arate frames or sections in the PIL for each I see their prescriptions. Pharmacists are also patient group. Perhaps there are other solu- confused. And having called the company for Thalidomide’s patent ran out long ago, but information, I discovered that company staff a company, Celgene, has patented a thalido- Generally, brand building is the opposite mide distribution system (as Pharmion has in of generic medicine; building double brands tients are not confused, but only because they some European countries.) The information certainly is. I believe that the issues around information here are so confusing and ob- scure that it takes us back to the old days of patent medicines and secret formulae.
ganisations delivering information for dis- I want regulatory restrictions to stop phar- smoking cessation and as Wellbutrin for de- pensing from bulk) is more generic and at pression. Fluoxetine from Lilly is the iconic brand name on a medicine. But if companies brand Prozac. Lilly also marketed fluoxetine Another example of mainly off-label use is are to be allowed to continue to have more as Sarafem (which has been licensed to an- misoprostol (Cytotec). In Norway, all infor- than one brand of the same drug, it should be other company.). The colours here are not identical. Prozac is green and cream. Sarafem, leaflets is about preventing gastrointestinal ul- should be generic, and that information in however, is pink, which may be considered a ceration during treatment with non-steroidal formularies and package inserts should not better colour for a medicine for the treatment anti-inflammatory drugs. But almost all uses of premenstrual tension. Allowing for differ- of the drug are for gynaecological purposes ent strengths, other dual brands are Yentreve (abortion, cervical priming, labour induc- Broad spectrum
and Cymbalta (duloxetine), and Propecia and The Broad Spectrum feature is open to any It is possible that if Vioxx had not been reader. Contributions of around 1,100 words commenting on topical issues should be sent creases the risk of double medication.The US chapters to its story. For example, there are patents and clinical evidence for rofecoxib (ISMP) has even reported a case of triple having an effect in preventing colorectal can- The Pharmaceutical Journal (Vol 278) 3 February 2007

Source: http://www.lyftingsmo.no/labelling/Presentations/Dual%20branding.pdf