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To the Editor.—
While the authors stop short of a recommendation of all of the manufacturers of penicillin listed (63 different manufacturers are shown in Table 2), the basis of their presentation is that the physician select the lowest-priced producer in any group—if that producer is individually acceptable to the prescriber. The criterion used in such a determination is "informed judgment." Now the physician is asked to inform himself of the pharmacokinetic data of several vendors of the product of his choice.In making this selection, he might assume that each product is approved by the Food and Drug Administration; therefore, equivalence is implied. Because of vendor variability, as well as batch variability with a single vendor, this assumption lacks the foundation demanded by most clinicians.With two chemically equivalent products, clinical equivalance can be assured only if the plasma concentration-time curve following a single dose for the one product
Lazarus HL. Cost of Drugs. JAMA. 1974;229(5):520. doi:10.1001/jama.1974.03230430014007