FDA Ensures Equivalence of Generic Drugs
Drug products sold in the United States are approved by the FDA
whether they are brand name or generic. "Most people believe that if
something costs more, it has to be better quality. In the case of generic
drugs, this is not true," says Gary Buehler, Director of FDA's Office
of Generic Drugs. "The standards for quality are the same for brand
name and generic products."
Despite the strict standards imposed by the FDA for approval of generic
drugs, and their enforcement of these standards, a number of
misconceptions about generic drugs persist (See "Myths and Facts
about Generics" to the right).
New drugs, like other new products, are developed under patent
protection. The patent protects the investment in the drug's development
by giving the company the sole right to sell the drug while the patent is
in effect. When patents or other periods of exclusivity on brand-name
drugs are near expiration, manufacturers can apply to the FDA to sell
generic versions.
"Much of FDA's review of generic drugs and brand name drugs is the
same," Buehler explains (See "Same FDA Requirements for
Brand-Name and Generic Drugs" below). There are eight major parts to
the FDA's review of a firm's application to sell a generic drug:
- There must be an FDA-approved brand-name drug that is the reference
for the proposed generic. The generic must have the same active
ingredient or ingredients and the same labeled strength as this
reference product. It must have the same dosage form-tablets, patches
and liquids are examples of dosage forms. It must be administered the
same way, for example, swallowed as a pill or given as an injection.
- The manufacturer must show the generic drug is "bioequivalent"
to the brand-name drug (See "What Is Bioequivalence?"
below).
- The generic drug's labeling must be essentially the same as that of
the approved drug.
- The firm must fully document the generic drug's chemistry,
manufacturing steps, and quality control measures. Each step of the
process must be detailed for FDA review.
- The firm must assure the FDA that the raw materials and the finished
product meet USP specifications, if these have been set. The USP, or
U.S. Pharmacopoeia, is the non-profit, scientific body chartered by
Congress to set standards for drug purity in this country.
- The firm must show that its generic drug maintains stability as
labeled before it can be sold. Once on the market, the firm must
continue to monitor the drug's stability. The firm must show that the
container and its closure system won't interact with the drug. Firms
making sterile drugs must submit sterility assurance data showing
microbiologic integrity of these products.
- The firm must provide a full description of the facilities it uses
to manufacture, process, test, package, label and control the drug. It
must certify that it complies with federal regulations about current
good manufacturing practices and undergo FDA inspection of the
manufacturing facility to assure compliance.
- Before FDA approves a generic drug, it usually conducts an
inspection at the proposed manufacturing site to make sure the firm is
capable of meeting its application commitments and to ensure the firm
can manufacture the product consistently.
"Generic competition helps keep the cost of drugs down,"
Buehler says. "It also encourages the research based drug companies
to keep finding newer and better
medicines that have patent protection."
When retired federal auditor Stuart Addison went to the pharmacy, he
had the pharmacist fill his prescriptions with generic drugs. "My
motivation is to keep the prices down," Addison said, noting that his
insurance plan helped pay for his prescriptions. "My pocketbook isn't
directly affected; but, in the long run, I'm helping to keep insurance
premiums down." Generic drugs save consumers an estimated $8 to $10
billion a year at retail pharmacies (according to the Congressional Budget
Office). Even more billions are saved when hospitals use generics.
"FDA-approved generic drugs are bioequivalent and therapeutically
equivalent to their brand-name counterparts," says Buehler.
"People can use them with total confidence."
Same FDA Requirements for Brand-Name and Generic Drugs
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Brand Name Drug
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Generic Drug
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For reformulations of a brand-name drug or generic versions of a
drug, FDA reviews data showing the drug is bioequivalent to the
one used in the original safety and efficacy testing.
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FDA evaluates the manufacturer's adherence to good manufacturing
practices before the drug is marketed.
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FDA reviews the active and inactive ingredients used in the
formulation before the drug is marketed.
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FDA reviews the actual drug product.
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FDA reviews the drug's labeling.
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Manufacturer must seek FDA approval before making major
manufacturing changes or reformulating the drug.
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Manufacturer must report adverse reactions and serious adverse
health effects to the FDA.
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FDA periodically inspects manufacturing plants.
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FDA monitors drug quality after approval.
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Myths and Facts about Generic Drugs
MYTH: Generics take longer to act in the body.
FACT: The firm seeking to sell a generic drug must show that its
drug delivers the same amount of active ingredient in the same timeframe
as the original product.
MYTH: Generics are not as potent as brand-name drugs.
FACT: FDA requires generics to have the same quality, strength,
purity, and stability as brand-name drugs.
MYTH: Generics are not as safe as brand-name drugs.
FACT: FDA requires that all drugs be safe and effective and that
their benefits outweigh their risks. Since generics use the same active
ingredients and are shown to work the same way in the body, they have the
same risk-benefit profile as their brand-name counterparts.
MYTH: Brand-name drugs are made in modern manufacturing
facilities, and generics are often made in substandard facilities.
FACT: FDA won't permit drugs to be made in substandard facilities.
FDA conducts about 3,500 inspections a year in all firms to ensure
standards are met. Generic firms have facilities comparable to those of
brand-name firms. In fact, brand-name firms account for an estimated 50
percent of generic drug production. They frequently make copies of their
own or other brand-name drugs but sell them without the brand name.
MYTH: Generic drugs are likely to cause more side effects.
FACT: There is no evidence of this. FDA monitors reports of adverse
drug reactions and has found no difference in the rates between generic
and brand-name drugs.
What Is Bioequivalence?
Generics are not required to replicate the extensive clinical trials
that have already been used in the development of the original, brand-name
drug. These tests usually involve a few hundred to a few thousand
patients. Since the safety and efficacy of the brand-name product has
already been well established in clinical testing and frequently many
years of patient use, it is scientifically unnecessary, and would be
unethical, to require that such extensive testing be repeated in human
subjects for each generic drug that a firm wishes to market. Instead,
generic applicants must scientifically demonstrate that their product is
bioequivalent (i.e., performs in the same manner) to the pioneer drug.
One way scientists demonstrate bioequivalence is to measure the time it
takes the generic drug to reach the bloodstream and its concentration in
the bloodstream in 24 to 36 healthy, normal volunteers. This gives them
the rate and extent of absorption-or bioavailability-of the generic drug,
which they then compare to that of the pioneer drug. The generic version
must deliver the same amount of active ingredients into a patient's
bloodstream in the same amount of time as the pioneer drug.
Using bioequivalence as the basis for approving generic copies of drug
products was established by the Drug Price Competition and Patent Term
Restoration Act of 1984, also known as the Hatch-Waxman Act. Brand-name
drugs are subject to the same bioequivalency tests as generics when their
manufacturers reformulate them.
This article originally appeared in the September 1999 Special Report,
"From Test Tube to Patient: Improving Health Through Human
Drugs"
U.S. Department of Health and Human Services
Public Health Service - Food and Drug Administration
The contents of this publication--both text and graphics--are not
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permission from FDA. Credit to the U.S. Food and Drug Administration as
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informed about the use of our materials. Contact CDER at 1 (888) INFO-FDA.
Consumer Education: Generic Drugs
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Consumer Education
FDA/Center for Drug Evaluation and Research
Last Updated: January 6, 2003
Originator: OTCOM/DPA
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