Truth About Generics
SUSAN J. GROMACKI, OD, MS, FAAO
Do you prescribe
generic lens solutions to 30 percent of your patients? Is one out of every
four starter kits you dispense labeled with a store name such as Kmart or CVS? Of
then, are our patients purchasing generic products at a high rate? In a word, price.
Are they getting the best value for their dollars? Do they know what's in the generic
bottle? Do you?
What's in the Bottle?
Current Formulations of Private Label
Solutions (At Press Time)|
to ReNu MultiPlus|
||similar to ReNu MultiPlus|
||Opti-One, similar to Aquify|
||Opti-One, similar to Aquify|
||similar to Aquify|
|Aquify and/or Sauflon|
|*smaller retailers, distributed by KC Pharmaceuticals|
All generic solutions aren't the same. In fact, they're not necessarily
the same as name-brand products, or even another bottle of an identically labeled
solution. Every year or so, a retailer entertains bids on which company will produce
its private-label solution. When the contract expires, the formulation may change.
With expiration dates typically 18 to 36 months into the future, two different formulations
could reside in bottles sitting side-by-side on the supermarket shelf.
A single retailer also can purchase more than one formulation.
For example, CVS sells both Opti-One (Alcon) and a solution similar to Aquify (CIBA
Vision). Meijer, meanwhile, currently sells only a solution similar to Aquify
but in different-colored packages placed next to the corresponding name-brand product
on the shelf. The green-labeled box, for example, claims, "If you like Opti-Free
Express, try me." Although legal, only the savviest patient understands that the
active ingredients in Aquify and Opti-Free Express (Alcon) are completely different.
Clinical significance: When suspecting solution hyper-
or incompatibility, look at your patient's bottle so you can read the active ingredients
and ascertain if solution is playing a role.
Because contracts generally go to the lowest bidder, most generics
contain older formulations. An exception to the rule is Aquify (Table 1).
Oldies But Goodies?
Older formulations have been and are perfectly fine. But trouble
can happen, for example, in that neither ReNu MultiPlus nor Opti-One is FDA-indicated
for use with silicone hydrogel contact lenses. Although some older solutions may
cause some asymptomatic corneal staining, the newer, premium products are associated
with fewer of these observations.
Clinical significance: For silicone hydrogel patients, dispense
samples of only those solutions that are indicated by the FDA for use with silicone
hydrogel lenses. Carefully instruct patients that no substitutions are allowed.
Prescribe a Solution
We've made great advances in solutions over the past few years;
the patient who buys generic often isn't benefiting from that technology. The challenge
is communicating that to patients.
Dispensing a complimentary care kit of your preferred solution
is a good start. Some practitioners reinforce this by "prescribing" it on a prescription
pad; others provide detailed handouts while others review the advantages of these
products. Whatever you choose, communication is the key to ensuring that our patients
are using what is best for their eyes. CLS
Dr. Gromacki is in group
practice in Burke, Virginia, and has served as a faculty member at the University
of Michigan Department of Ophthalmology and Visual Sciences.
Contact Lens Spectrum, Issue: December 2005