The BOTTOM LINE: Talk to your doctor to see if there is any benefit for you to warrant switching from the brand-name drug to the generic option. For most patients, there will be no need to consider switching from the brand drug.
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This week's "Ask Dr. Durie" comes from a patient who has been watching the news and has seen indications about generic forms of medicine being available for the treatment of multiple myeloma. And so, the question is: Is it okay to take a generic form of medicine?
Well, the good news is that when these generic medicines become available, they have to be approved by the FDA. This is rather a rigorous process. And so, in general, generic medicines can be considered to be safe and equivalent to the original brand medication. Large studies have not been conducted with the generic form of medicine, but in general, it should be largely equivalent.
And so, recently it was announced that a generic form of Revlimid®, generic lenalidomide, was going to be available. And so, now instead of Revlimid, there is the option for generic lenalidomide.
And then there are also available generic forms of Velcade®, bortezomib. Bortezomib by intravenous injection has been available for a few years now, and recently by subcutaneous shot, bortezomib is now available.
And so, we have those medications potentially available for myeloma patients to consider. So, what are the pros and cons? Well, potentially, one of the advantages is that the generic could be cheaper and could cost less. However, the pricing is quite complicated and at this moment it is hard to say, in an individual case depending on the status of Medicare or private insurance, if there are or will be advantages in terms of cost for individual patients.
And so, the very good news is that both patients and doctors, certainly, for the time being, can select. Will they continue with the brand Revlimid or Velcade or switch to the generic lenalidomide and bortezomib?
That choice is there and lacking a particular cost or other advantages, most likely, there's no really strong reason for a majority of patients to consider switching but to perhaps just continue with the brand that they may have been using for quite some time—possibly years.
The BOTTOM LINE about generic medicines is that it is extremely important to talk to your local doctor about them and see what the pros and cons are in your exact case. In most instances right now, chances are it will be feasible and recommended just to continue with your regular brand medication, but things will evolve, and we just need to stay alert to any updates in terms of news related to cost or any other issues, but good to know that there is that option there. But you don't need to immediately jump over to that generic formulation.
Professor of Medicine, Hematologist/Oncologist, and Honoree MD at the University of Brussels, Dr. Brian G.M. Durie is a co-founder of the IMF and a member of the IMF Board of Directors.
