Generics for Cellcept and Prograf

[ahamner]

I have heard that generics are supposed to become available for these two drugs in the next one to two years.  Does anybody know any more information on this?

[willieandwinnie]

ahamner there are already generics for Prograf (generic name:  tacrolimus), and CellCept (generic name:  mycophenolate mofetil). 

[KT0930]

Double and triple check with your transplant team before making the switch. I went to a transplant wellness conference a couple of weeks ago, and my neph was leading one of the workshops. His advice was to avoid generic immune suppressants with the exception of myfortic (generic cell cept). His argument is that they are not identical to the one they are replacing.

[Slywalker]

Good info to have KT - thanks.

Sandyb

 

[ahamner]

Double and triple check with your transplant team before making the switch. I went to a transplant wellness conference a couple of weeks ago, and my neph was leading one of the workshops. His advice was to avoid generic immune suppressants with the exception of myfortic (generic cell cept). His argument is that they are not identical to the one they are replacing.

I had also heard of this concern and your advice is appreciated.

[ahamner]

ahamner there are already generics for Prograf (generic name:  tacrolimus), and CellCept (generic name:  mycophenolate mofetil). 

Even though the generics exist, are they available in the US?  (Not ordered from Canada or Japan)

[willieandwinnie]

ahamner, yes, they are available in the US, but as KT said, make sure your doctor is the one to prescribe them. Not all  immune suppressants are the same. 

[kellyt]

I was also told not to get the generic Prograf or Cellcept.  I had heard this already from IHD, so I didn't ask any questions.  My copay for the Prograf and Cellcept is like $55 each, so I'm not that upset.  It's the freaking Valcyte thats killing me now.  My copay/patient responsibility is like $263.  I can't wait to end this medication!!!!!  It's my highest!!!

[Slywalker]

Oh Kelly - the Valcyte is outrageous - I wonder how dare those drug companies charge that  - and then I remember - hmmm, because they can.  My prescription medication plan sends out a form that shows what the med costs, what the plan pays and what my co-pay is.  For 90 valcyte pills it listed the cost as $5000.  WHAT?   The health care thing is so "ass end" backward in this country in my mind.  Why does Medicare only cover transplant meds for three years?  Did you know some university actually spent grant money on a study that said that for the population that uses medicare has a larger failed rate of transplants when that population can no longer afford the meds?  DUH!!! Wish they had paid me the research money. 

Sandyb

 

[kellyt]

No kidding.  They could pay me in  MEDICATION!  ha ha

What keeps me sane is that I know the Valcyte will end in four months.  Problem is, I think I only received 15 days or something like that.  I have yet to order and pay for a full month's supply.

That's another thing!  I took all my meds to the hospital, they wrote them down and then they had my husband take them home.  THEN they gave me the same medications and will CHARGE me per pill!   THAT is OUTRAGEOUS!!!!!!  Why can't they just give me MY mediation that I ALREADY PAID FOR!!!!!!!!!!  Then again, out of all my meds I'm only taking ONE (Zetia).  Everything was scrapped.  I'll go through them and see if anyone here could use them.  I just got some from my 90-day supplier.  I'll talk to my physician first to be sure I won't need them in the near future.

My transplant doctor said that I could bring them to the clinic and they could use them.  But I'd rather give them to someone here!  They didn't give me any discounts!!!!!

[Meinuk]

Generic Cell Cept (mycophenolate mofetil)

There have been many new FDA Approvals this spring, and this is going to become an issue. When my TX nephrologist writes a script for no substitutions, my insurer 1199 will not cover the medication.  They will cover the generic, which is FDA approved, but the bio availability parameters are based on a 1 dose 500 milligram study with scores ranging from 80% - 108 % 

See study pdf http://www.apotex.com/us/en/products/downloads/bio/myco_imtb_be.pdf

Although my center would REALLY prefer that I use the name brand, I am going to have to continue with the generic (this can be appealed, lots of paperwork and time, but generally the appeal process is positive - after a month or so).  Which will mean more testing than I would normally need.  (which actually pleases me, as my insurer will HAVE to pay for the additional testing)

In a perfect world, I wish that everyone could have the best care and medication available.  Unfortunately, we don't.  And, though I don't really have complete confidence in the veracity of the studies, I am putting my trust??!?? in the federal government!!!???.  It is a numbers game, and fingers crossed, these numbers are solid enough.  Or should I say "close enough for government work".

Roache U.S. Pharmaceuticals have made A LOT of money on Cell Cept since they have had the patent, and if they are not lowering their prices to compete with the new manufacturers, then I wonder how they will use their influence to encourage our docs to keep writing prescriptions for Cell Cept, when our insurers are forcing us to use generics.

In this case, I feel like a medical lab rat, and a commercial lab rat. It is going to be an interesting summer.  I'll keep updating as I hear and/or experience more....

FYI - I have always had private insurance, it paid for my dialysis, my transplant and now my meds.  I hadn't thought of using Medicare, but if they will cover Cell Cept (not the generic) I may consider it - and there you have it, in the end, the government ends up paying.


FDA Approval  - No information about the studies linked to the FDA website.  (Never a good sign) Here is what little they have for the drug my pharmacy is substituting (MFG: APOTEX) :  http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails

[chris73]

I got refill(new prescription) on cellcept today but is was generic, i was disappointed where i have been getting the real thing all along. I planning on calling tx clinic to express my concern tommorrow about this matter! Am i overacting or not?  Why change something  that has been working? Hate to loose my kidney over a anti rejection drug!!  Anyone taking generic Cellcept?    God Bless!!  Chris

[Chris]

Surprised I missed this topic.

Last month my pharmacy sent me a letter that they will be using generic CellCept unless requested by me or written on the prescription. So I called this month to have them send brand name and not generic. This was also a topic at a transplant seminar I went to in May of this year. They reccommend that patients who have been on CellCept or Prograf for a number of years not to switch. Only those who have recently gotten a transplant may switch due to not enough study on long term effect.

However, the question becomes how will Medicare handle this in the future. I don't want to switch and have potential problems or go thru weekly blood test.

[monrein]

We aren't using generics here in Canada for either Cellcept or Prograf.  We do use many generics but if there is any kind of tolerance issue then we get switched. 

[chris73]

tx made the correction back on cellcept ...they understood my conern...

[monrein]

 

[willieandwinnie]

We get our medications through mail order and they haven't tried switching Len's prograf to generic (YET) but our doctors have said that they will make sure they write Dispense as written. Some of these generics scare me. 

[Chris]

I agree w&w. I was on Norvasc and the insurance didn't want to cover it, so it was switched to nifedipine. This pill was for a orse! Compared to the Norvasc in size and side effects, I never had the control of my BP like I had with Norvasc. Finally now have a diferent generic BP med that is about the same size and also take Diovan HCT to finally have my BP under control. I can't also stand to take generic Reglan either, that gives me a side effect Reglan does not give me and I will not take it due to the side effect.

[KT0930]

Medicare covers name brand prograf and cellcept completely. Under my private insurance (blue cross), I paid $45 per month per anti rejection. I don't pay anything with Medicare.

[Meinuk]

I am into week two of the CellCept generic by Apotex MYCOPHENOLATE MOFETIL, none are really worried.  My Neph or my Renal Fellow.

There are dispensing options to say with the "Designer Drug" there are other versions of MYCOPHENOLATE MOFETIL, drug companies are smart.  Even though the FDA approval process is not as exhaustive with generics, the patent owners can tinker a bit with the delivery system (make it enteric coated, or time release (in the case of Prograf)) and there you have it, a new patented drug that is the same as the one who's patent has expired.  And the insurance companies Approve them as a different drug. 

It is all big business and window dressing. No wonder health care is in such dire straits.  We can transplant one person's kidney into another person, but we can't pay for the medication to keep it working.  Something is wrong with this picture.  The medicine should be the hard part, not the economics.

 

[chris73]

well said  Meinuk!!!! I want to switch jobs but i dont want to leave my insurance, i cant afford my meds without it...plus preexisting conditions play a part too...