Generic clopidogrel works as well as more expensive brand-name counterpart

Generic clopidogrel was equally effective as the brand-name antiplatelet Plavix for an older population with acute coronary syndrome (ACS), according to a study published in Circulation: Cardiovascular Quality and Outcomes.

Researchers analyzed the combined rates of death and recurrent ACS among 12,643 patients prescribed Plavix and 11,887 prescribed one of the less-expensive versions of generic clopidogrel in Ontario, Canada, from 2009 to 2014. They found 17.9 percent of patients prescribed generics met that endpoint within one year of follow-up compared to 17.6 percent of those given Plavix, a nonsignificant difference. In addition, there were similar rates of bleeding complications, all-cause rehospitalizations and stroke/transient ischemic attack.

“People can safely use generic clopidogrel. This large and real-world study should be reassuring to physicians and healthcare organizations who have been concerned about changing what is prescribed,” said Dennis T. Ko, MD, MSc, lead study author and senior scientist at the Institute for Clinical Evaluative Sciences in Toronto.

Patent protection for Plavix expired in 2012, allowing drug makers to manufacture generic versions of the versatile drug shown to improve clinical outcomes following ACS, percutaneous coronary intervention, stroke and peripheral vascular disease.

But in Canada and the U.S., generic drugs are subjected to less rigorous testing than their brand-name counterparts, leading to concerns about whether they will truly result in similar clinical outcomes, the researchers noted.

At least in this case, providers should be reassured about the efficacy of generic clopidogrel, Ko said. The patient population in this study was 57 percent men and age 77 on average—a group at high risk for adverse events.

An added benefit of this finding, Ko said, is the potential cost savings associated with the equivalent generic. Plavix cost $2.58 per pill in Canadian dollars in 2010, whereas generic clopidogrel currently costs $0.39 per pill.

“Plavix was one of the most commonly used drugs in cardiology, so switching to generics can reduce a lot of cost for individuals and health systems,” Ko said.

The researchers noted they pooled several generic drug offerings into one group for the study, but also found no significant differences in results when the drugs were analyzed separately.