Zoë finds out a rose is NOT a rose! And generic Concerta is NOT Concerta, unless you’re in the province of Ontario

I admit it, just about the only thing I do every single day is get up. But – you think I’M inconsistent?! What about the coverage of ADHD meds benefits?

Ok, so today’s Pet Peeve is a good news / bad news story. While some improvements have been made in cost coverage of ADHD meds in Canada, there’s inconsistency in services, depending on what province you live in (and I’m pretty sure it’s the same in the U.S.A.).

And the cost savings of the generic over the original Concerta may not be worth it because it’s looking like the “generic” is not all it’s cracked up to be.  Researching this has just about cracked me up.

Changes in Ontario in less than four years

In my own province of Ontario, here’s what’s changed in the 4 years since my diagnosis in August, 2006:

• Ritalin was covered by social assistance funding (aka welfare benefits) but Concerta was not
• No generic form of Concerta was available
• Concerta was fully covered for a while
• A generic form of Concerta was introduced, suddenly coverage of Concerta is iffy. The price difference for Concerta, 36 mg, is $105.00 / 30 tablets; $75.57 / 30 tablets for generic brand called Teva Methylphenidate (aka Nova Methylphenidate; the name is in the process of being switched over from “Nova” to “Teva;” it’s the same drug)
• Recently, patients taking Concerta in the provinces of Ontario, British  Columbia and New Brunswick can get a “Multi-use Patient Co-Pay Assist Program” card from their doctor or pharmacist. The card is from Janssen Ortho, the original manufacturer of Concerta.  It covers the difference of the cost between the generic and the original Concerta.  This is important because it appears that the generic is not actually a direct substitute for Concerta, in other words, it’s not the same, and there are some indications that it doesn’t work as well.  Ontario consumers are forced to use the generic form of Concerta in many cases, and those on social assistance have no choice in the matter, unless their pharmacy is willing to dispense Concerta and have the patient pay the difference OR unless they can get their hands on one of these handy-dandy cards. The card will let you get Concerta each time you fill your prescription (in other words, it’s “multi-use”).

Multi-use Patient Co-Pay Assist Program Card

Social assistance (welfare) drug benefit coverage

This is just a sampling of inconsistencies in meds coverage in Canada [as of July 30, 2010].  It is NOT a full-blown study, but based on a survey with pharmacists from a few random drug stores across Canada.  I surveyed the provinces of Newfoundland, Nova Scotia, New Brunswick, Ontario and Alberta.

EVERY one of these provinces covers Ritalin, Ritalin SR.
All but Newfoundland covers Dexedrine.
Only Ontario covers Adderall and Biphentin.
Only Ontario covers the generic Concerta, aka Teva-Methylphenidate.  Concerta is no longer covered, except as stated above.
NONE of the provinces covers  Strattera or Vyvanse.

FOR MORE INFORMATION for Ontario coverage:  FORMULARY SEARCH (shows if a generic is avb., etc.) and there is an alternative drug benefit program called TRILLIUM offered by the Ministry of Health and Long-Term Care.  E-mail them at trillium@resolve.com
(I have been aware of this program for years, have a file w/the appc’n form, but, you know – paperwork! I want to slit my wrists every time I read the first page…I think I have ADHD)

Troubling inconsistencies in the “generic” Concerta

When I did my brief survey, that’s when I found out that the so-called “generic” form of Concerta isn’t an equivalent at all. One pharmacist in Newfoundland told me that Janssen Ortho had sent out a memo that it wasn’t an equivalent for their original Concerta and may not have the same therapeutic effects.

In fact, only Ontario’s Ministry of Health has deemed Teva-Methylphenidate (the generic brand) to be “interchangeable” with Concerta.  All other provinces surveyed told me it had been deemed NOT INTERCHANGEABLE with Concerta and therefore was not dispensed as a generic equivalent.

The problems with the “generic” form are that, firstly, no one can seem to find any information on it, except that it doesn’t seem to be released the same way as Concerta. This is a big problem, because the reason why Concerta’s so great in the first place (at least, it has been for me) is because of its slow release mechanism.  I was completely taken aback when I was told by someone in a province thousands of kilometres away from me, that what I was being dispensed was actually not Concerta at all!

Another disadvantage of the generic form is that, like Ritalin, it can be abused. It was found that kids are selling Ritalin, which can then be crushed and snorted to get high, but you can’t do that with Concerta.  But guess what?  YOU CAN DO THAT WITH THE GENERIC VERSION! – Another distinct step backwards.

Thank you Dr. Kenny Handelman

For excellent and comprehensive coverage of the Concerta/Teva-Methylphenidate fiasco, I urge you to visit Dr. Handelman’s blog post, Generic Concerta in Canada.

Are we confused enough yet?

Now, I need my ADHD meds AND a pain killer!

OK, folks, I’ve been hammering away at today’s Pet Peeve all bloody day. My head is spinning. My eyes are stinging. I’m pissed off at the drug companies, at my pharmacy who didn’t tell me any of this when they dispensed my so-called generic Concerta, and generally just dismayed at the whole medication situation.

I urge you, especially if you’re taking Concerta, to read Dr. Handelman’s blog post and educate yourself. It’s a convoluted story, but man, it opened my eyes and it will help you make more informed decisions.

Caveat Emptor

The moral of today’s peeve is:  BUYER BEWARE!  We are NOT being told everything we need to know about our meds, nor are we being dealt with fairly across provinces and states. I know, I know, “Tell us something we don’t know, Zoë.”

Why don’t YOU tell US if YOUR ADHD medication is covered by your State or Provincial drug plan? It would be great to compile some helpful info. here for everyone. THANKS IN ADVANCE FOR YOUR HELP!

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From Psych Central's website:
Zoë’s Pet Peeves: Inconsistency in ADHD Accommodations for Kids | ADHD from A to Zoë (August 20, 2010)

From Psych Central's website:
Zoës Pet Peeves: ADHD Meds - Trials and Triumph! | ADHD from A to Zoë (August 27, 2010)

From Psych Central's website:
Generic Versus Name Brand Medications: Are They Equal? | ADHD from A to Zoë (October 18, 2011)

    Last reviewed: 30 Jul 2010