[Should the ophthalmologist prescribe generic drugs?].

It seems obvious that an ophthalmologist should encourage the use of generic drugs. However, it is important to know the exact definition of a generic drug and the type of studies to be conducted before a generic drug is released on the market. A generic drug is a drug that has the same composition quantitatively as well as qualitatively of the active compound as the original drug. It also has the same pharmaceutical mode of action and the same bioavailability, as determined with bioavailability studies. Ophthalmic drops contain both an active compound and many adjuvants used to stabilize the drug. Globally speaking, the active compound corresponds to the efficacy of a topical drug and the adjuvant to its tolerance. It is likely that the efficacy of a generic drug is identical to that of the brand-name drug, even though only bioavailability studies in non-human models are required to evaluate tolerance which is less likely to be identical, as adjuvants can differ. A survey of 520 French ophthalmologists has recently been conducted. It shows that doctors rarely think of prescribing generic drugs, as they do not consider cost as a major issue in treating glaucoma. However, they see no reason not to prescribe generic drugs. This mixed perception is shared by patients who willingly accept that doctors prescribe a generic drug, but do not wish the pharmacist to take the initiative of filling a prescription with a generic drug, which sometimes gives patients the impression of being less well treated. The use of generic drugs should be encouraged, keeping in mind that good tolerance should be ensured.