Anti-depressant

Deborah Hill Cone, ‘How Pharmac stole my holiday’, regards her opinion piece as a “bona fide public service announcement”. However, at best it is a misguided commentary on a personal experience.

Certainly, her pharmacist should have discussed the brand change with her, and this may have alleviated her concerns. However, the symptoms Deborah describes, which occurred “within a day”, cannot be attributed to a change in venlafaxine brand and nor could it have resulted in serotonin toxicity — something both her doctor and pharmacist should have been able to reassure her of.

Deborah questions Medsafe’s standards for generic equivalence. Generic equivalence is defined similarly by all international regulatory bodies and requires the generic version to demonstrate that both its overall bioavailability and maximum plasma concentration are within the 80-125 per cent of confidence limits of those of the originator brand.

A University of Auckland study of some 10,000 venlafaxine users between 2011 and 2013 could find no difference in health outcomes for those who changed to generic venlafaxine.

Of concern is that with only 12 per cent of patients switching to the generic brand at the time of the study, the opportunity to save millions of dollars was lost. This is the crux of the matter. Pharmac is often blamed for limiting access to new and expensive technologies, yet when an opportunity arises to make savings and enable the funding of these new medicines, the public seems reluctant. Dr Charon Lessing, lecturer in

pharmacology, AUT.