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Discussion on Considerations when using "Generic" joint meds
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Member:
lmiller
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Posted on Tuesday, Feb 19, 2013 - 3:13 pm:
Hello all,
I recently was given this link to an Equine Chronicle discussing the use of so-called "generic" joint meds, most often labeled as surgical lavage solution or the like, by my vet. It contains a number of good points, and I though those who are considering Adequan alternates might benefit from reading. There is also a link to an adjunct article by notable CA vet regarding his decision making process.
Happy Reading!
https://www.chronofhorse.com/article/are-we-returning-wild-west-veterinary-medic ine
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Member:
arary
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Posted on Saturday, Feb 23, 2013 - 10:59 pm:
While you do have to use careful consideration before using just any old compounded drug or "medical device," I'm not sure that I agree with the article. Perhaps the problem is not the use of non-FDA approved drugs or off label use. Perhaps the real problem is the cost of the FDA approved drugs. If the process wasn't so expensive and the drug companies so greedy, we wouldn't need to use these alternatives.
My old vet sells his own version of Gastroguard that he has compounded specifically for his practice. It works well and this has been proven by endoscopic testing at his clinic. His stated reason for doing this when there is an FDA approved drug available? Clients cannot afford $1100 for Gastroguard, so horses were going untreated. They can, however, afford $375 for the compounded product. I suppose this hurts the drug companies, but it only helps the horses and the owners. He also recommends IV administration of Polyglycan instead of Legend or Adequan. It's affordable and works great. It lasts about 4 weeks and the results are clearly visible in how well the horses respond. Everybody in the area was doing it, and I never saw a single problem.
How can the drug companies justify the ridiculous cost of Equioxx when Previcox is the same drug for a fraction of the cost? I could not afford to treat my horse with Equioxx but I could afford Previcox. How does it help people or horses when we have great FDA approved drugs that people can't afford? If there are cheaper alternative out there, I see no problem with using them. But I am of course not a vet, just an owner who loves her horse but lives on a teacher's salary. I'd be curious to see others' opinions on this.
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Member:
gramsey1
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Posted on Sunday, Feb 24, 2013 - 8:40 am:
https://www.chronofhorse.com/article/are-we-returning-wild-west-veterinary-medici ne
I read the article with great interest.
IMO, yes, we have chaos, induced by the drug companies. The drug companies have behaved unethically. Greed is evil, it is in no ones best interest. The AAEP was wrong to take a position in the matter. The drug companies are not stake holders in the AAEPs mission, practitioners, horses, and horse owners are their true stake holders. A little reality check here for the drug companies would have been helpful.
1200 lb Horse: Previcox treatment costs 60 cents per dose; Equioxx, 10 dollars per dose. Okay?
Here is a brief Ethics tutorial.
https://www.youtube.com/watch?v=xwOCmJevigw
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Moderator:
DrO
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Posted on Sunday, Feb 24, 2013 - 8:42 pm:
Hello All,
Guy, exactly what part of the AAEP position do you disagree with? Certainly it is within the purview of the Association that represents Equine Veterinarians to have an opinion on this matter.
I would personally consider the use of Previcox instead of Equioxx on my own horses due to cost but it would be wrong to represent the two drugs as equivalent. Previcox does not have the research supporting its efficacy in horses. The lack of efficacy of generic omeprazole represents a cautionary tale about the assumption that all generics are equivalent. The key to my mind is whether a truthful and appropriate representation of the product has been made. However this point of view seems to me the same as the AAEP, in this article at least.
It is the AVMA position that the use of alternative drugs between consenting and informed veterinarian and client is a punishable ethics violation that I find erroneous.
DrO
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Member:
gramsey1
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Posted on Monday, Feb 25, 2013 - 6:42 pm:
I agree with the AAEP position. But, I think they should not have commented. Ethics dictate that we always tell the truth. Ethics does not dictate what we always provide a response. If asked,"is it right or wrong to prescribe Previcox for Equine treatment", I would respectfully submit that it is not in the best interests of the stake holders of the AAEP to answer the question, stake holders being practitioners, horses, and horse owners.
I behave as you do. I discuss options, and recognize that use of Previcox is an off label use. My experience suggests it is safe, inexpensive and effective.
BTW, my experience with generic omeprazole was negative, inexpensive but ineffective.
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Member:
gramsey1
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Posted on Monday, Feb 25, 2013 - 7:32 pm:
Oh, I almost forgot. We had really good results on muscle pain with Naproxen. Previcox seems to work better on joint pain. The down side of Naproxen is 12 hour dosing and many more pills to crush, a 1000 lb horse takes 9 500 mg pills twice a day.
https://www.horseadvice.com/horse/messages/5/10871.html
We started at three times a day for three days then cut back to twice a day. We used this with a OTTB that had back pain problems (After x-ray showed no evidence of kissing spine). He is going great now.
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Member:
vickiann
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Posted on Tuesday, Feb 26, 2013 - 2:12 pm:
This whole Equioxx VS Previcox stuff reminds me of the Prilosec - Nexium deal.
Prilosec was available first at a VERY high price per tablet and then the patent ran out so the drug manufacturer came up with Nexium with the tiniest of (non-substantial) variation and that became the new prescription drug that many human doctors put everyone on when they could instead just buy Prilosec and take a higher dosage (some doctors do suggest doing just that), which had become available over-the-counter at a much lower price.
As to the "compounded" type of ulcer treatment, my equine Vet told me that using it was the equivalent of throwing my money away, because at least the compounded stuff that I had been sold, had practically no active ingredients in it. He prefers the GastroGard ulcer treatment.
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