The Way Generic Drugs Look Can Disrupt Use, Study Says

Researchers find that changes in pill appearance is associated with non-adherence.

Do looks really matter? When it comes to the appearance of pills, a new study says yes.

We all know that generic versions of prescription drugs can often look different than the more expensive version, and a new study published in the July 14 edition of the Annals of Internal Medicine, found that the difference in appearance can lead to patients not taking lifesaving medication.

Brigham and Women’s Hospital (BWH) researchers studied patients who recently suffered a heart attack and found that variation in appearance of generic drugs is associated with a greater risk of patients stopping their essential post-heart attack drugs.

“After patients have a first heart attack, guidelines mandate treatment with an array of long-term medications and stopping these medications may ultimately increase morbidity and mortality,” says Aaron S. Kesselheim, MD, assistant professor of medicine in the Division of Pharmacoepidemiology and Pharmacoeconomics at BWH and the senior investigator of this study. “Medications are essential to the treatment of cardiovascular disease and our study found that pill appearance plays an important role in ensuring patients are taking the generic medications that they need.”

According to the study:

In a large national insurance database, the researchers collected records of over 10,000 patients discharged between 2006 and 2011 after hospitalizations for heart attacks who initiated treatment with generic beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin-II-receptor blockers, or cholesterol-lowering statins. They then looked for breaks in medication refilling (non-adherence) and they determined whether the pill appearance had changed in the prior two prescriptions. They found that the odds that a patient would discontinue use or not refill their medication increased by 34 percent after a change in color and 66 percent after a change in pill shape.

“The association between changes in pill appearance and non-adherence to essential cardiovascular medications has important implications for public health,” Kesselheim said. “This study suggests the need for physicians and pharmacists to proactively warn patients about the potential for these changes, and reassure them that generic drugs are clinically interchangeable no matter how they look, especially in light of the prevalent use of generic drugs and public health importance of promoting patient adherence to essential medications.”