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Generic Drugs Equally Effective in Cardiovascular Disease

Meta-analysis dispels the notion that brand-name drugs are superior to generic medications

TUESDAY, Dec. 2 (HealthDay News) -- In the treatment of cardiovascular disease, evidence does not support the notion -- often expressed in journal editorials and the popular press -- that generic drugs are inferior to brand-name drugs, according to a report published in the Dec. 3 issue of the Journal of the American Medical Association.

Aaron S. Kesselheim, M.D., of Brigham and Women's Hospital and the Harvard Medical School in Boston, and colleagues conducted a meta-analysis of 47 studies -- 38 of them randomized controlled trials -- published between 1984 and 2008, which covered nine subclasses of cardiovascular medications.

Among the randomized controlled trials, the researchers observed that clinical equivalence was found between generic and brand-name drugs in 100 percent of the studies of beta-blockers, antiplatelet agents, statins, ACE inhibitors, alpha-blockers, narrow therapeutic index (NTI) drugs, antiarrhythmic agents and warfarin, in 91 percent of the studies of diuretics, and in 71 percent of the studies of calcium-channel blockers. They also noted that 53 percent of the editorials they reviewed expressed a negative opinion of generic drug substitution.

"Our results suggest that it is reasonable for physicians and patients to rely on U.S. Food and Drug Administration bioequivalence rating as a proxy for clinical equivalence among a number of important cardiovascular drugs, even in higher-risk contexts such as the NTI drug warfarin," the authors conclude. "These findings also support the use of formulary designs aimed at stimulating appropriate generic drug use."

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