Saturday, October 24, 2009

For MD/DO, PA, BSN, R.PH, Ph.D.,...will you comment on my opinion below?

Those smokers desperate to quit smoking often seek the advice of a physician. Physicians love to tell thier patients that Welbutrin and Zyban are "the same thing". But Zyban and Welbutrin are manufactured by varying methods: Zyban appears to be packed powder, while Welbutrin is a coated tablet. I believe the difference in manufacturing results in an alteration of the molecular structure of the native product; perhaps by one or two molecues. In taking Zyban, the sufferer receives the entire dosage at once. Welbutrin is coated, and the dose is received in a slower, and uniform manner. The Placebo Effect: is very real. The brain interprets Welbutrin to be a real medicine that will produce real results. Conversley, the brain interprets Zyban as another marginal anti-smoking gimmick and thus it is not as effective as Welbutrin. Welbutrin is better known as an anti-depressant. Call your formulary/pharmacy; if they are the same thing, why the incredible price difference?
Answer:
yeah, they are a little bit different. they arent considered bioequivlents. both are time released but they vary in release rate, thats why they are considered 2 different drugs. personally i doubt there is any difference in the chemical structure of the two products though. Why is there a price difference? because name adds value to a product. do you think coke or pepsi costs anymore to make than a store brand cola? why is it double the price? because people know the name and will pay it. it only costs pennies to actually manufacture the drugs so theyre both marked up quite a bit anyway (they need to make money for research to make future drugs, advertising, etc.). this practice is called rebranding, and it happens quite a bit in pharmacy. when a patent expires, a rival company will make a new brand name drug with the same formula and act like its a new drug, or theyll tweak the time release a bit or something and get a new patent. Claritan and Alavert (over the counter allergy meds) are also the same thing, but Alavert is cheaper since Claritan was the original and is better known (and generic loratidine is way cheaper than both). its just a marketing tactic. and why do insurance companies pay? it may appear one is cheaper than they other, but the insurance companies get deals and rebates and stuff so it might not be as bad of a move as it looks. plus sometimes FDA approvals will vary (im not sure if it does in this case i didnt look it up, but thats a possibility)also, the average person probably doesnt even know theyre the same thing so there probably isnt much placebo effect. lots of people dont even know the names of their medications, they just come into the pharmacy and ask for a refill on the "red ones" or "round white things" or whatever.
Wellbutrin and Zyban have the same active chemical (bupropion), but are packaged in different vehicles. Zyban is a 12-hour extended release formulation which should be roughly equivalent to Wellbutrin SR.I don't disagree that the placebo effect is real, I just don't see that it would apply here. Why would a patient think that an antidepressant would be more effective than a drug that is specifically marketed for smoking cessation? If you had arthritis and I told you to choose between the arthritis medication and the heart medication, which would you choose? That is the whole reason GlaxoSmithKline rebranded Zyban and got FDA approval for this indication. It is a marketing strategy to encourage more people to use it for smoking cessation.There is virtually no price difference between Zyban and Wellbutrin SR if you pay out of pocket. At drugstore.com, both are around $155-165 for 60 count of the 150 mg dose. If your insurance is paying then there will likely be a huge difference for you because most insurance companies will cover Wellbutrin, but not Zyban. You seem to suggest that Wellbutrin is much more expensive than Zyban. This should not be the case if you are getting the same dosages (Wellbutrin is available in higher dosages than Zyban.
Their sales departments have decided on different marketing strategies. You'll note that the recommendation for smoking cessation is to take it for a matter of a couple of weeks, at which time the drug has reached a steady state, so there's really no difference of any significance. In terms of changed molecular structure, that would make it a different drug and require a complete new FDA approval process. You really don't have enough to do, do you?
grimmy tea is right on. i could not have said it better myself :)

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