I'm pissed. I might be late to this party but I just found out some disturbing information about the prescription drug Wellbutrin and its evil generic twin, Bupropion.
Am I the only person with this dilemma? I don't think so: U.S. sales of brand and generic Wellbutrin XL 300mg were $581 million for the 12 months ending June 2008 according to IMS Health data.
Without going into the gory details, I was prescribed Wellbutrin several years ago for depression. Wellbutrin worked great for me.
At some point (around 2006), the generic version of Wellbutrin arrived. I like cheap generic drugs as much as the next person but only when they work.
I started feeling lousy again. I've spent the past couple of years changing medications from Wellbutrin, Buproprion, Cymbalta and Effexor. Eventually I got tired of all the doctor appointments and just decided this must be the best it's gonna get, so deal with it.
Today, I started researching and found out that generic Wellbutrin has a reputation for not working for some people. There were so many complaints that the FDA ("investigated" the problem but the issue was with the patients, not the generic drug.
So what about the FDA's Official-Looking Statement That Really Sounds Convincing But Basically Costs Us Millions of Dollars Because It Says Something Always Works When It Doesn't? Here's one thing it says:
What other factors [besides the generic version sucking] could account for the reported [negative] effects following a switch [to the generic]?
Natural history of depression
A factor that may account for the instances of recurring depression in the reported cases (see above) is the natural history of major depression, which can recur despite continued treatment, and has been shown to do so in controlled clinical studies.
Or to paraphrase: All the people who felt worse after switching to Bupropion just happened to all start feeling worse at the same time.
Here's the kicker:
The FDA considers the generic form of bupropion XL 300 mg (Teva Pharmaceuticals) bioequivalent and therapeutically equivalent to (interchangeable with) Wellbutrin XL 300 mg.
If they said "However, in some cases, patients might have negative results and it is recommended they go back to Wellbutrin" that would've allowed me to get my prescription at a reasonable cost. (I could prove to Caremark there's a factual basis for needing the name brand.) More importantly and devastating for the FDA and the pharmaceutical corporations, the headline in the paper would've screamed: First Ever Reported Case of Generic Drug Not Performing As Well As Original. Then, we'd all freak out whenever our doctor recommended a generic.
And I'm curious:
Why didn't GlaxoSmithKline, who created the drug in the first place, fight the FDA ruling if patients were saying the generic doesn't work? If the generic is deemed ineffective, wouldn't that increase their profits? Or have they already made their millions and moved on to the next great drug?
I also found out that if I wanted to take my chances and see if Wellbutrin would work better for me than the generic, my yearly cost for Wellbutrin would be $992.84 more expensive per year than the generic.
I debated if I could afford it and decided yes, my kids are growing up too fast not to enjoy life and be a better mom. I even calculated the daily cost: Wellbutrin will cost me $2.72 extra per day. Is feeling like a normal person worth an extra $2.72 a day? I decided yes.
So I called my doctor to request a prescription for the name brand Wellbutrin. I was all prepared to demand my rights to receive the name brand instead of a generic and refuse to come in for a doctor visit just to switch (these days they won't help you at all without coming in for a visit and pay that co-pay), but the person gladly took my information, looked me up in the computer and said "Okay, you're all set!"
So I just switched, over the phone, from one drug that costs $80 a year to a different drug that is virtually identical in every way (according to the FDA) but the new drug costs $1,072.84 a year.
I wish I could report a happy ending, but I just called the doctor's office an hour ago, so I don't know yet if switching back to Wellbutrin will work for me. But I wanted to share this information with anybody else out there who's taking Wellbutrin or Bupropion. I'm hoping Wellbutrin will work for me in time for the holidays (well, Christmas anyway).
If anybody knows how to get United Healthcare to pay for a name brand prescription even when there's a generic available, I'd love to hear about it.
For anybody who wants to read more, there's this , this , this , this , this and this which talks about how they'll market Wellbutrin as a Seasonal Affective Disorder solution now that Bupropion took over the depression market.
Update:
The doctor’s office got the last laugh: they faxed my prescription to Caremark as Bupropion, completely screwing up my request. I already have plenty of Bupropion, so now I’m paying extra money for a crap Rx I don’t need.
Several people mentioned in the comments that generics are especially tricky if there’s any type of time release, "extended release" or "suspended release" involved. So, on Friday, I’m going to call the doctor’s office yet again and ask for the non-time release or non-sustained release version of Bupropion.
You know what’s funny? Between the doctor’s office screwup and some smart people on Daily Kos, I just might end up finding the right prescription and saving hundreds of dollars! If they hadn’t screwed up, I’d have a $268 charge on my credit card right now instead of $20.
Thanks to everybody for your help and comments. Any prescription I decide to try will have to be signed-off-on by my doctor of course, but I’m getting better advice here than at my doctor’s office.