Patients do as well on generic antiplatelet drugs as more expensive brand-name product

March 13, 2018, American Heart Association

Generic anti-platelet drugs seem to work as well as a brand name drug for heart patients, according to new research in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.

When a Canadian health system switched from prescribing the brand-name anti-platelet drug Plavix to a far-cheaper generic version, and chest pain were no more likely to die from any cause or be re-hospitalized for a attack or unstable angina within a year than those prescribed Plavix (17.9 percent vs. 17.6 percent).

In addition, there were no significant differences between the drug groups in the percent of patients who died or were hospitalized for any reason; had a stroke or ; or who developed bleeding as a side effect of treatment.

"People can safely use generic clopidogrel. This large and real-world study should be reassuring to physicians and healthcare organizations who have been concerned about changing what is prescribed," said Dennis T. Ko, M.D., M.Sc., lead study author and senior scientist at the Institute for Clinical Evaluative Sciences (ICES) in Toronto.

In Canada and the United States, generic drugs are approved based on small studies in healthy people showing that the active ingredient is released at equivalent levels and over the same timeframe. That suggests, but doesn't prove, that the generic product will also have the same safety and medical benefit.

Clopidogrel is used to treat patients with , , stroke or peripheral vascular disease.

Researchers compared outcomes in patients (average age 77, 57 percent male) who were prescribed clopidogrel after hospitalization for a heart attack or heart-related chest pain (unstable angina) in Ontario, Canada, where the Ministry of Health began to automatically substitute generic clopidogrel for Plavix once the brand name drug's patent expired in 2012. Between 2009 and 2014, 12,643 patients were prescribed Plavix and 11,887 generic clopidogrel.

Plavix cost about $2.58 Canadian dollars per pill in 2010 and was projected to cost the Ontario Drug Benefit Program $72.8 million by 2012. But by switching to a generic, which costs $0.39 per pill in 2018, the expense was only $19 million Canadian dollars.

"Plavix was one of the most commonly used drugs in cardiology, so switching to generics can reduce a lot of cost for individuals and health systems," said Ko, who is also a cardiologist at the Schulich Heart Centre of the Sunnybrook Health Sciences Centre at the University of Toronto.

While the study was conducted in Canada, the results should apply to the United States, even if the generic offerings are slightly different, according to the researchers.

"There are quite a few different generic brands. In this study, we considered them as a group, but later found no differences in outcome when we compared between different generics," said co-principal investigator Cynthia Jackevicius, Pharm.D., M.Sc., professor of pharmacy at Western University of Health Sciences and senior adjunct scientist at ICES.

The American Heart Association recommends clopidogrel—sometimes in combination with other drugs—for patients who have had acute coronary syndrome ( or heart attack) or stroke.

Explore further: Plavix's new generic status could be boon for patients

More information: Circulation: Cardiovascular Quality and Outcomes (2018). DOI: 10.1161/CIRCOUTCOMES.117.004194

Related Stories

Plavix's new generic status could be boon for patients

May 15, 2012
(HealthDay) -- The blockbuster drug Plavix (clopidogrel), used to prevent clotting in some heart patients, will go off patent in the United States on Thursday, making it considerably more affordable.

Generic versions of plavix approved

May 18, 2012
(HealthDay) -- The first generic versions of Plavix (clopidogrel bisulfate) have been approved by the U.S. Food and Drug Administration.

Personalized approach to selecting antiplatelet drugs improves outcomes

March 12, 2018
Patients with acute coronary syndrome experienced a substantially lower rate of heart attack, stroke, death from cardiovascular causes and major bleeding at 12 months if genetic information was used to inform the selection ...

Adverse events spike after blood pressure meds go generic in Canada

October 3, 2017
One month after generic versions of three widely-used blood pressure drugs became available in Canada, hospital visits for adverse events spiked in generic drug users, according to new research in Circulation: Cardiovascular ...

More potent anti-clotting drugs with angiography may benefit patients with acute chest pain

August 15, 2013
Current methods to treat acute coronary syndrome conditions, such as heart attack, include artery-clearing procedures (e.g., percutaneous coronary intervention or coronary artery bypass grafting) with medications, or medications ...

Recommended for you

'Smart stent' detects narrowing of arteries

June 19, 2018
For every three individuals who have had a stent implanted to keep clogged arteries open and prevent a heart attack, at least one will experience restenosis—the renewed narrowing of the artery due to plaque buildup or scarring—which ...

Marriage may protect against heart disease / stroke and associated risk of death

June 18, 2018
Marriage may protect against the development of heart disease/stroke as well as influencing who is more likely to die of it, suggests a pooled analysis of the available data, published online in the journal Heart.

Deaths from cardiac arrest are misclassified, overestimated

June 18, 2018
Forty percent of deaths attributed to cardiac arrest are not sudden or unexpected, and nearly half of the remainder are not arrhythmic—the only situation in which CPR and defibrillators are effective—according to an analysis ...

Tick-borne meat sensitivity linked to heart disease

June 15, 2018
University of Virginia School of Medicine researchers have linked sensitivity to an allergen in red meat—a sensitivity spread by tick bites—with a buildup of fatty plaque in the arteries of the heart. This buildup may ...

Tobacco aside, e-cigarette flavorings may harm blood vessels

June 14, 2018
Flavor additives used in electronic cigarettes and related tobacco products could impair blood vessel function and may be an early indicator of heart damage, according to new laboratory research in Arteriosclerosis, Thrombosis ...

The molecules that energize babies' hearts

June 14, 2018
A metabolic process that provides heart muscle with energy fails to mature in newborns with thickened heart walls, according to a Japan–Canada research team.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.