Aaron Toe

HUS-108
Article on Pharmacology
Topic: Differences In Generic Pill haracteristics !ay "ea# To Interr$ptions In %ssntial !e#ication
Use &!'T !e#ical 'e(s To#ay)
*an+ ,0
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-01,
Generic me#ications c$rrently acco$nt for o.er /0 percent of prescriptions #ispense#+ Ho(e.er0
(hile generic #r$gs are clinically 1ioe2$i.alent to the 1ran#-name .ersion0 they often #iffer in their
physical characteristics0 s$ch as color an# shape+ 3esearchers from 4righam an# 5omen6s Hospital
&45H) ha.e fo$n# that some patients (ho recei.e generic #r$gs that .ary in their color are o.er 70
percent more li8ely to stop ta8ing the #r$g0 lea#ing to potentially important an# potentially a#.erse
clinical effects+
The st$#y (as p$1lishe# electronically on Decem1er ,10 -01- in the Archi.es of Internal
!e#icine+
9Pill appearance has long 1een s$specte# to 1e lin8e# to me#ication a#herence0 yet this is the
first empirical analysis that (e 8no( of that #irectly lin8s pills6 physical characteristics to patients6
a#herence 1eha.ior09 e:plaine# Aaron S+ ;esselheim !D0 *D0 !PH0 assistant professor of me#icine in
the Di.ision of Pharmacoepi#emiology an# Pharmacoeconomics at 45H0 an# principal in.estigator of
this st$#y+ 95e fo$n# that changes in pill color significantly increase the o##s that patients (ill stop
ta8ing their #r$gs as prescri1e#+9
The researchers con#$cte# a case-control st$#y of patients ta8ing antiepileptic #r$gs an#
compare# the o##s that patients (ho #i# not refill their me#ication ha# 1een gi.en pills that #iffere# in
color or shape from the prior prescriptions+ Using a large national #ata1ase of fille# prescriptions0 (hen
the researchers i#entifie# a 1rea8 in the patient6s $se of the #r$g0 they loo8e# at the pre.io$s t(o
prescription fillings to see if they (ere the same color an# shape+ They fo$n# that interr$ptions in the
prescription filling occ$rre# significantly more fre2$ently (hen the pills ha# #ifferent color+
Interr$ptions in antiepileptic #r$g $se for e.en a fe( #ays can raise the ris8 of sei<$re an# ha.e
important me#ical an# social conse2$ences for patients+
These fin#ings offer important ta8e-home messages for physicians0 pharmacists0 an# patients+
As ;esselheim e:plaine#0 9Patients sho$l# 1e a(are that their pills may change color an# shape0 1$t
that e.en #ifferently-appearing generic #r$gs are appro.e# 1y the =DA as 1eing 1ioe2$i.alent to their
1ran#-name co$nterparts an# are safe to ta8e+ Physicians sho$l# 1e a(are that changes in pill
appearance might e:plain their patients6 non-a#herence+ =inally0 pharmacists sho$l# ma8e a point to tell
patients a1o$t the change in color an# shape (hen they change generic s$ppliers+9
3esearchers ac8no(le#ge that me#ication a#herence is a m$lti-facete# iss$e0 1$t s$ggest that
ta8ing steps to permit &or e.en re2$ire) similarity in pill appearance among 1ioe2$i.alent 1ran# name
an# generic #r$gs may offer a relati.ely simple (ay to contri1$te to 1etter a#herence+