Additionally if I owned a fruit store and my scale was off to the degree a pharma scale is allowed to be I would be fined for every pound of bananas I sold, plus everything else I sold. I never take a generic if I can afford it because I never know if one , they will work, or 2) if the meds are perfect raw but the various binders prevent the release of the product in the proper place, like say only in intestines not the stomache or reverse, 3) meds may be perfect and perfectly pressed, but not be enough to be efficatious. ADHD (ADD) meds are the best example. the right amount works wonders, too little and they are pointless. You may have to titrate a person for two months if you can afford the copays till you figure out what to give the kid.

Additionally, I do not know the time frame, but the pens/mugs/10 dollar lunches are out now and have been for a while. I have neighbors who are both drug reps, I know a well respected medical chemical engineer as well as several doctors all of whom I have discussed drugs with over the past 30 years. Interestingly the Chemical engineer explained to me in extreme detail how stuff is made and the differences between generics (in general) and very specific ones and makers. Would he take a generic, admittedly there were few.

And self regulation is a big issue as well. Vitarene on Long Island was falsefying documentation for years and they finally were closed maybe 10 years ago. A certain big pharma company wasn’t seeing the increase in profits fast enough from a certain statin and then came up with the idea that more statin reuced the levels better. They went out and pushed this idea through the reps. Sales went wild, duh it only works in a small percent of the users, and it only decreases it by a tiny amount.

S otony I do blieve you mean well, but, I think you are off base here.

Perhaps Dr Cobbs can elaborate on the relationships that the AACE, The Endocrine Society, and the American Thyroid Assn share with Abbott Labs, the makers of Synthroid? Just a cursury search online brings up a whole host of examples of just how Abbott supports all these societies and helps them to stay in business.. Are we really supposed to believe that these endocrine societies are going to bite the hand that feeds them and, god forbid, promote or even give equal time to either natural desiccated thyroid or generic brands? And I assume that you, Dr Cobb have never attended a drug sponsored lunch, dinner, or any event designed to promote their products? Nor ever invited an Abbott Labs drug rep into your office with the resultant pens, mugs, pads and other goodies?
There has been too much exposed about Big Pharma’s cozy associations with the organizations, societies and doctors that help promote their products. The facts, indeed, stand for themselves.

There is no myth if you read the literature. Since so many people misunderstand the facts, a joint position paper was published on the internet.
AACE, The Endocrine Society and the American Thyroid Association published the joint statement. The statement was published after the FDA refused to listen to the opinions of all three groups of endocrinologists. The joint statement is the one that states that branded levothyroxine should be used instead of generics. And it was issued in 2004

Also for the record, the FDA allows for significant variance from the stated dosage. Some generics are more “bioavailable” and others are less available resulting in differing thyroid function test results despite all claiming to be the exact same strength using FDA standards. Differing manufacturing techniques account for the differences.

As for the Boots paper, Boots was wrong in withholding their paper however a careful review of the other published literature reveals many other papers that demonstate differences in blood levels of different brands even when the dosage claims to be the same.

For the record, I am not a paid speaker for any pharmaceutical company. I have taught and continue to teach endocrinology to residents, attending physicians and medical students for more than 20 years. I prefer to deal with facts as represented in the published literature. A drug company paid speaker gives a promotional lecture. Don’t expect facts from them.

The facts stand for themselves. The recommendation to use branded levothyroxine is that of AACE, The Endocrine Society and the American Thyroid Association. I stand by the recommendation of all three associations of endocrinologists. The facts speak for themselves.