Skip to main content
Log in

Are Generic Drugs Used in Cardiology as Effective and Safe as their Brand-name Counterparts? A Systematic Review and Meta-analysis

Drugs Aims and scope Submit manuscript

Abstract

Background

Previous systematic reviews (2008; 2016) concluded similarity in outcomes between brand-name and generic drugs in cardiology, but they included ≥ 50% comparative bioavailability studies, not designed or powered to detect a difference in efficacy or safety between drug types. We aimed to summarise best-evidence regarding the effectiveness and safety of generic versus brand-name drugs used in cardiology.

Methods

For this systematic review of the literature, scientific databases (MEDLINE and EMBASE) were searched from January 1984 to October 2018. Original research reports comparing the clinical impact of brand-name versus generic cardiovascular drugs on humans treated in a real-life setting, were selected. Meta-analyses and subgroup analyses were performed. Heterogeneity (I2) and risk of bias were tested.

Results

Among the 3148 screened abstracts, 72 met the inclusion criteria (n ≥ 1,000,000 patients, mean age 65 ± 10 years; 42% women). A total of 60% of studies showed no difference between drug types, while 26% concluded that the brand-name drug was more effective or safe, 13% were inconclusive and only 1% concluded that generics did better. The overall crude risk ratio of all-cause hospital visits for generic versus brand-name drug was 1.14 (95% confidence interval: 1.06–1.23; I2: 98%), while it was 1.05 (0.98–1.14; I2: 68%) for cardiovascular hospital visits. The crude risk ratio was not statistically significant for randomised controlled trials only (n = 4; 0.92 [0.63–1.34], I2: 35%).

Conclusion

The crude risk of hospital visits was higher for patients exposed to generic compared to brand-name cardiovascular drugs. However, the evidence is insufficient and too heterogeneous to draw any firm conclusion regarding the effectiveness and safety of generic drugs in cardiology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Association Canadienne du Médicament Générique. Les faits. 2017. http://generiquescanadiens.ca/les-faits/medicaments-generiques/. Accessed 27 septembre 2017

  2. Santé Canada. Ligne directrice - Normes en matière d’études de biodisponibilités comparatives: Formes pharmaceutiques de médicaments à effets systémiques. 2018. https://www.canada.ca/fr/sante-canada/services/medicaments-produits-sante/medicaments/demandes-presentations/lignes-directrices/biodisponibilite-bioequivalence/normes-matiere-etudes-biodisponibilite-comparatives-formes-pharmaceutiques-medicaments-effets-systemiques.html. Accessed 29 octobre 2018

  3. Leclerc J, Blais C, Rochette L, et al. Did Generic Clopidogrel Commercialization Affect Trends of ER Consultations and Hospitalizations in the Population Treated with Clopidogrel? Drugs Aging. 2019.

  4. Leclerc J, Blais C, Rochette L, et al. Trends in hospital visits for generic and brand-name warfarin users in Quebec, Canada; a population-based time series analysis. Am J Cardiovasc Drugs. 2018;19(3):287–97.

    Google Scholar 

  5. Leclerc J, Blais C, Rochette L, et al. Impact of the commercialization of three generic angiotensin II receptor blockers on adverse events in Quebec, Canada: a population-based time series analysis. Circ Cardiovasc Qual Outcomes. 2017;10:1–9.

    Google Scholar 

  6. Ko DT, Krumholz HM, Tu JV, et al. Clinical outcomes of plavix and generic clopidogrel for patients hospitalized with an acute coronary syndrome. Circ Cardiovasc Qual Outcomes. 2018;11:e004194.

    PubMed  Google Scholar 

  7. Jackevicius C, Tu JV, Krumholz HM, et al. Comparative effectiveness of generic atorvastatin and lipitor(R) in patients hospitalized with an acute coronary syndrome. J Am Heart Assoc. 2016;5(4):e003350.

    PubMed  PubMed Central  Google Scholar 

  8. Kesselheim AS, Misono AS, Lee JL, et al. Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysis. JAMA J Am Med Assoc. 2008;300:2514–26.

    CAS  Google Scholar 

  9. Manzoli L, Flacco ME, Boccia S, et al. Generic versus brand-name drugs used in cardiovascular diseases. Eur J Epidemiol. 2016;31:351–68.

    CAS  PubMed  Google Scholar 

  10. Davit B, Braddy AC, Conner DP, et al. International guidelines for bioequivalence of systemically available orally administered generic drug products: a survey of similarities and differences. The AAPS J. 2013;15:974–90.

    PubMed  Google Scholar 

  11. Alter D. When do we decide that generic and brand-name drugs are clinically equivalent? Perfecting decisions with imperfect evidence. circulation: cardiovascular quality and outcomes. 2017;10.

  12. Cochrane. Guides and handbooks. 2017. http://training.cochrane.org/handbooks. Accessed 16 novembre 2017

  13. Higgins JPT, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

    PubMed  PubMed Central  Google Scholar 

  14. Sterne JAC, Hernan M, Reeves BC, et al. ROBINS-I: a tool for assessing risk of bias in non-randomized studies of interventions. BMJ. 2016;355:1–7.

    Google Scholar 

  15. Flacco ME, Manzoli L, Boccia S, et al. Registered randomized trials comparing generic and brand-name drugs: a survey. Mayo Clin Proc. 2016;91:1021–34.

    PubMed  Google Scholar 

  16. Leclerc J. Surveillance des consultations à l’urgence et des hospitalisations chez les utilisateurs de médicaments génériques et originaux en cardiologie, au Québec. Université Laval; 2017. p. 447.

  17. Santé Canada. MedEffet Canada. 2019. https://www.canada.ca/fr/sante-canada/services/medicaments-produits-sante/medeffet-canada.html. Accessed 27 juin 2019

  18. U.S. Food and Drug Administration (FDA). FDA Adverse Event Reporting System. 2019. https://www.fda.gov/drugs/fda-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-electronic-submissions. Accessed 12 juin 2019

  19. Sharoky M, Perkal M, Tabatznik B, et al. Comparative efficacy and bioequivalence of a brandname and a generic triamterene-hydrochlorothiazide combination product. Clini Pharm. 1989;8:496–500.

    CAS  Google Scholar 

  20. Saseen JJ, Porter JA, Barnette DJ, et al. Postabsorption concentration peaks with brand-name and generic verapamil: a double-blind crossover study in elderly hypertensive patients. J Clin Pharmacol. 1997;37:526–34.

    CAS  PubMed  Google Scholar 

  21. Neutel JM, Smith DHG. A randomized crossover study to compare the efficacy and tolerability of Barr warfarin sodium to the currently available Coumadin. Cardiovasc Rev Rep. 1998;19:49–59.

    Google Scholar 

  22. Swenson CN, Fundak G. Fundak. Observational cohort study of switching warfarin sodium products in a managed care organization. Am J Health-syst Pharm AJHP. 2000;57:452–5.

    CAS  PubMed  Google Scholar 

  23. Assawawitoontip S, Wiwanitkit V. A randomized crossover study to evaluate LDL-cholesterol lowering effect of a generic product of simvastatin (Unison company) compared to simvastatin (ZocorTM) in hypercholesterolemic subjects. J Med Assoc Thail. 2002;85:S118–24.

    Google Scholar 

  24. Milligan PE, Banet GA, Waterman AD, et al. Substitution of generic warfarin for Coumadin in an HMO setting. Ann Pharmacother. 2002;36:764–8.

    PubMed  Google Scholar 

  25. Ol’binskaia LI, Danilogorskaia IA. Efficacy, safety, and pharmaco-economical aspects of the therapy for dyslipidemia with brand-name and generic statins. Terapevticheskii arkhiv. 2003;75:47–50.

    PubMed  Google Scholar 

  26. Witt DM, Tillman DJ, Evans CM, et al. Evaluation of the clinical and economic impact of a brand name-to-generic warfarin sodium conversion program. Pharmacotherapy. 2003;23:360–8.

    PubMed  Google Scholar 

  27. Ashraf T, Ahmed M, Talpur MS, et al. Competency profile of locally manufactured clopidogrel Lowplat and foreign manufactured clopidogrel Plavix in patients of suspected ischemic heart disease (CLAP-IHD). JPMA J Pak Med Assoc. 2005;55:443–8.

    PubMed  Google Scholar 

  28. Lee HL, Kan CD, Yang YJ. Efficacy and tolerability of the switch from a branded toa generic garfarin sodium product: an observer-blinded, randomized, crossover study. Clin Ther. 2005;27:309–19.

    CAS  PubMed  Google Scholar 

  29. Pereira JA, Holbrook AM, Dolovich L, et al. Are brand-name and generic warfarin interchangeable? Multiple N-of-1 randomized, crossover trials. Ann Pharmacother. 2005;39:1188–93.

    CAS  PubMed  Google Scholar 

  30. Ahrens W, Hagemeier C, Muhlbauer B, et al. Hospitalization rates of generic metoprolol compared with the original beta-blocker in an epidemiological database study. Pharmacoepidemiol Drug Saf. 2007;16:1298–307.

    PubMed  Google Scholar 

  31. Kim SH, Kim YD, Lim DS, et al. Results of a phase III, 8-week, multicenter, prospective, randomized, double-blind, parallel-group clinical trial to assess the effects of amlodipine camsylate versus amlodipine besylate in korean adults with mild to moderate hypertension. Clin Ther. 2007;29:1924–36.

    CAS  PubMed  Google Scholar 

  32. Tran YBL, Frial T, Miller PSJ. Statin’s cost-effectiveness: a Canadian analysis of commonly prescribed generic and brand name statins. Can J Clin Pharmacol. 2007;14:e205–14.

    PubMed  Google Scholar 

  33. Loebstein R, Katzir I, Vasterman-Landes J, et al. Database assessment of the effectiveness of brand versus generic rosiglitazone in patients with type 2 diabetes mellitus. Med Sci Monit. 2008;14:CR323–6.

    PubMed  Google Scholar 

  34. Tsinamdzgvrishvili B, Trapaidze D, Loladze N, et al. Efficacy of adipin and normodipin (generic drugs of amlodipine) vs norvsc in treatment of essential hypertension. Georgian Med News. 2008;154:14–7.

    Google Scholar 

  35. Kim SH, Chung WY, Zo JH, et al. Efficacy and tolerability of two formulations of ramipril in Korean adults with mild to moderate essential hypertension: an 8-week, multicenter, prospective, randomized, open-label, parallel-group noninferiority trial. Clin Ther. 2009;31:988–98.

    CAS  PubMed  Google Scholar 

  36. Jeong YH, Koh JS, Kang MK, et al. The impact of generic clopidogrel bisulfate on platelet inhibition in patients with coronary artery stents: results of the ACCEL-GENERIC study. Korean J Intern Med. 2010;25:154–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Kim SH, Park K, Hong SJ, et al. Efficacy and tolerability of a generic and a branded formulation of atorvastatin 20 mg/d in hypercholesterolemic Korean adults at high risk for cardiovascular disease: a multicenter, prospective, randomized, double-blind, double-dummy clinical trial. Clin Ther. 2010;32:1896–905.

    CAS  PubMed  Google Scholar 

  38. Sicras Mainar A, Navarro Artieda R. Influence of substitution of brand name for generic drugs on therapeutic compliance in hypertension and dyslipidemia. Gaceta Sanitaria. 2010;24:473–82.

    Google Scholar 

  39. Boh M, Opolski G, Poredos P, et al. Therapeutic equivalence of the generic and the reference atorvastatin in patients with increased coronary risk. Int Angiol. 2011;30:366–74.

    CAS  PubMed  Google Scholar 

  40. Ghate SR, Biskupiak JE, Ye X, et al. Hemorrhagic and thrombotic events associated with generic substitution of warfarin in patients with atrial fibrillation: a retrospective analysis. Ann Pharmacother. 2011;45:701–12.

    CAS  PubMed  Google Scholar 

  41. Khosravi AR, Pourmoqhadas M, Ostovan M, et al. The impact of generic form of clopidogrel on cardiovascular events in patients with coronary artery stent: Results of the OPCES study. J Res Med Sci. 2011;16:640–50.

    PubMed  PubMed Central  Google Scholar 

  42. Tsadok MA, Jackevicius CA, Rahme E, et al. Amiodarone-induced thyroid dysfunction: brand-name versus generic formulations. CMAJ. 2011;183:E817–23.

    PubMed  PubMed Central  Google Scholar 

  43. Bobrova OP, Petrova MM. Comparison of pharmacokinetics and pharmacodynamics of the original and generic enalapril in the elderly patients with arterial hypertension. Ration Pharmacother Cardiol. 2012;8:149–53.

    Google Scholar 

  44. Fukuhara C, Kaneshige C, Akiyama K, et al. Difference in efficacy between a brand-name product (Adalat CR) and a generic product (nifedipine CR “sawai”) in hypertensive patients on hemodialysis. Jpn J Clin Pharmacol Ther. 2012;43:387–92.

    Google Scholar 

  45. Grigor’eva NI. Assessment of therapeutic equivalence of original bisoprolol and its generics in patients with ischemic heart disease with concomitant chronic obstructive pulmonary disease. Kardiologiia. 2012;52:10–4.

    PubMed  Google Scholar 

  46. Kwong WJ, Kamat S, Fang C. Resource use and cost implications of switching among warfarin formulations in atrial fibrillation patients. Ann Pharmacother. 2012;46:1609–16.

    PubMed  Google Scholar 

  47. Martsevich SY, Kutishenko NP, Ginzburg ML, et al. The KARDIOKANON study: a way to settle the subject of clinical equivalence of generic and original drugs. Ration Pharmacother Cardiol. 2012;8:179–84.

    Google Scholar 

  48. Oberhansli M, Lehner C, Puricel S, et al. A randomized comparison of platelet reactivity in patients after treatment with various commercial clopidogrel preparations: the CLO-CLO trial. Arch Cardiovasc Dis. 2012;105:587–92.

    PubMed  Google Scholar 

  49. Park YM, Ahn T, Lee K, et al. A comparison of two brands of clopidogrel in patients with drug-eluting stent implantation. Korean Circ J. 2012;42:458–63.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Solangi NA, Ahmed SP, Soomro K. Cholesterol, triglycerides and LDL lowering effects of generic products of simvastatin and HDL effect as compared to original brand of simvastatin in hypercholesterolemic subjects—A randomized study. Med Channel. 2012;18:41–4.

    Google Scholar 

  51. Srimahachota S, Rojnuckarin P, Udayachalerm W, et al. Comparison of original and generic clopidogrel 600 mg loading dose in the patients who planned undergoing coronary angiography. J Med Assoc Thai. 2012;95:1495–500.

    PubMed  Google Scholar 

  52. Tsoumani ME, Kalantzi KI, Dimitriou AA, et al. Antiplatelet efficacy of long-term treatment with clopidogrel besylate in patients with a history of acute coronary syndrome: comparison with clopidogrel hydrogen sulfate. Angiology. 2012;63:547–51.

    PubMed  Google Scholar 

  53. Colombo GL, Agabiti-Rosei E, Margonato A, et al. Off-patent generic medicines vs off-patent brand medicines for six reference drugs: a retrospective claims data study from five local healthcare units in the Lombardy Region of Italy. PloS one. 2013;8:e82990.

    PubMed  PubMed Central  Google Scholar 

  54. Haas AV, Martin-Doyle W, Vellanki A, et al. Statin switching: Trends in LDL-C and predictors of ATP-III goal attainment. Circulation. 2013;128:A14759.

    Google Scholar 

  55. Huang JH, Cheng HS, Chung CC, et al. Comparisons of clinical efficacy and safety between the brand- and generic-name fenofibrate in patients with hypertriglyceridemia. Exp Clin Med (Taiwan). 2013;5:136–8.

    CAS  Google Scholar 

  56. Kalo Z, Abonyi-Toth Z, Rokszin G, et al. Impact of switching on health care costs and outcomes in generic drug policies. Value Health. 2013;16:A537.

    Google Scholar 

  57. Malyhina AI, Zhuravleva MV, Starodubtsev AK, et al. The problem of medicines interchangeability Focus on perindopril. Ration Pharmacother Cardiol. 2013;9:505–10.

    Google Scholar 

  58. Martsevich SY, Tolpygina SN, Zakharova AV, et al. A comparative study of efficacy and tolerability of generic and original low-dose bisoprolol/hydrochlorothiazide combination in patients with arterial hypertension of 1-2 degrees. Results of clinical randomized crossover study. Ration Pharmacother Cardiol. 2013;9:511–8.

    Google Scholar 

  59. Szczotka B, Jazwinska-Tarnawska E, Wedlarski R, et al. Evaluation of efficacy and safety of hypertension treatment with original angiotensin-converting enzyme inhibitors. The comparison of original and generic formulations. Polski Merkuriusz Lekarski. 2013;34:140–4.

    PubMed  Google Scholar 

  60. Tsivgoulis G, Christoforidou A, Tsakaldimi S, et al. Monitoring of clopidogrel-related inhibition in patients presenting with acute cerebral ischemia following generic substitution of clopidogrel for cardiovascular prevention. Stroke. 2013;44:ATP413.

    Google Scholar 

  61. Balandina Y, Tarlovskaya Y, Maksimchuk-Kolobova N. Comparison of “simvastatin” medications according to hypolipidemic effects and from pharmacoeconomic point of view. Atherosclerosis. 2014;235:e260.

    Google Scholar 

  62. Corrao G, Soranna D, Arfe A, et al. Are generic and brand-name statins clinically equivalent? Evidence from a real data-base. Eur J Intern Med. 2014;25:745–50.

    PubMed  Google Scholar 

  63. Corrao G, Soranna D, Merlino L, et al. Similarity between generic and brand-name antihypertensive drugs for primary prevention of cardiovascular disease: evidence from a large population-based study. Eur J Clin Invest. 2014;44:933–9.

    CAS  PubMed  Google Scholar 

  64. Gagne JJ, Choudhry NK, Kesselheim AS, et al. Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study. Ann Intern Med. 2014;161:400–7.

    PubMed  Google Scholar 

  65. Kovacic JC, Mehran R, Sweeny J, et al. Clustering of acute and subacute stent thrombosis related to the introduction of generic clopidogrel. J Cardiovasc Pharmacol Ther. 2014;19:201–8.

    CAS  PubMed  Google Scholar 

  66. Maskon O, Parasi NS, Hassan CHH, et al. Head to head comparison between original and generic clopidogrel using multiple electrodes platelet aggregometry in stable patients with indication for therapy with P2Y12 inhibitor. J Am Coll Cardiol. 2014;63:A230.

    Google Scholar 

  67. Seo KW, Tahk SJ, Yang HM, et al. Point-of-care measurements of platelet inhibition after clopidogrel loading in patients with acute coronary syndrome: comparison of generic and branded clopidogrel bisulfate. Clin Ther. 2014;36:1588–94.

    CAS  PubMed  Google Scholar 

  68. Syvolap VV, Franskavichene LV, Golukhova EZ, et al. Switching from generic to brand clopidogrel in male patients after ST-elevated myocardial infarction. Cardiology (Switzerland). 2014;129:103–5.

    CAS  Google Scholar 

  69. Vichairuangthum K, Chotenoparatpat P. Comparison of original and generic enoxaparin for treatment of coronary artery disease patients undergoing percutaneous coronary intervention. J Am Coll Cardiol. 2014;63:S41–2.

    Google Scholar 

  70. Hamilos M, Saloustros I, Skalidis E, et al. Comparison of the antiplatelet effect of clopidogrel hydrogenosulfate and clopidogrel besylate in patients with stable coronary artery disease. J Thromb Thrombolysis. 2015;40:288–93.

    CAS  PubMed  Google Scholar 

  71. Komosa A, Siller-Matula JM, Kowal J, et al. Comparison of the antiplatelet effect of two clopidogrel bisulfate formulations: plavix and generic-Egitromb. Platelets. 2015;26:43–7.

    CAS  PubMed  Google Scholar 

  72. Choo DW, Wu FL, Wang J, et al. Comparative effectiveness of brand-name and generic warfarin on stroke and bleeding events in atrial fibrillation patients: a 6-year population-based retrospective cohort study in Taiwan. Value Health. 2016;19:A639.

    Google Scholar 

  73. Hellfritzsch M, Rathe J, Stage TB, et al. Generic switching of warfarin and risk of excessive anticoagulation: a Danish nationwide cohort study. Pharmacoepidemiol Drug Saf. 2016;25:336–43.

    PubMed  Google Scholar 

  74. Malinova L, Furman N, Dolotovskaya P, et al. Switch to potent P2Y12 inhibitor in ST elevation myocardial infarction: role of platelet reactivity testing. Eur Heart J Acute Cardiovasc Care. 2016;5:352–3.

    Google Scholar 

  75. Ntalas IV, Kalantzi KI, Tsoumani ME, et al. Salts of clopidogrel: investigation to ensure clinical equivalence: a 12-month randomized clinical trial. J Cardiovasc Pharmacol Ther. 2016;21:516–25.

    PubMed  Google Scholar 

  76. Tarlovskaya EI, Chudinovskih TI. Comparative prospective clinical economic study of original and generic bisoprolol in patients with coronary heart disease. Kardiologiia. 2016;56:12–7.

    CAS  PubMed  Google Scholar 

  77. Hajizadeh R, Ghaffari S, Ziaee M, et al. In vitro inhibition of platelets aggregation with generic form of clopidogrel versus branded in patients with stable angina pectoris. J Cardiovasc Thorac Res. 2017;9:191–5.

    PubMed  PubMed Central  Google Scholar 

  78. Lee JH, Kim SH, Choi DJ, et al. Efficacy and tolerability of two different formulations of atorvastatin in Korean patients with hypercholesterolemia: a multicenter, prospective, randomized clinical trial. Drug Design Dev Ther. 2017;11:2277–84.

    CAS  Google Scholar 

  79. Loch A, Bewersdorf JP, Kofink D, et al. Generic atorvastatin is as effective as the brand-name drug (LIPITOR) in lowering cholesterol levels: a cross-sectional retrospective cohort study. BMC Res Notes. 2017;10:291.

    PubMed  PubMed Central  Google Scholar 

  80. Leclerc J, Blais C, Rochette L, et al. Impact of the commercialization of three generic angiotensin II receptor blockers on adverse events in Quebec, Canada: a population-based time series analysis. Circ Cardiovasc Qual Outcomes. 2017;10:e003891.

    PubMed  Google Scholar 

  81. Pollak P, Herman RET, Feldman R. Therapeutic differences in 24-h ambulatory blood pressure in patients switched between bioequivalent nifedipine osmotic systems with differing delivery technologies. Clin Trans Sci. 2017;10:217–24.

    CAS  Google Scholar 

  82. Chanchai R, Kanjanavanit R, Leemasawat K, et al. Clinical tolerability of generic versus brand beta blockers in heart failure with reduced left ventricular ejection fraction: a retrospective cohort from heart failure clinic. J Drug Assess. 2018;7:8–13.

    PubMed  PubMed Central  Google Scholar 

  83. Desai RJ, Gopalakrishnan C, Dejene S, et al. Comparative outcomes of treatment initiation with brand-name versus generic warfarin: a medicare cohort study. Pharmacoepidemiol Drug Saf. 2018;27:403–4.

    Google Scholar 

  84. Dinic M, Maillard N, Bouiller M, et al. Generic vs brand-name drugs for the treatment of hypertension. J Hypertens. 2018;36:e123.

    Google Scholar 

  85. Gengo F, Westphal E, Aladeen T, et al. Generic clopidogrel: has substitution for brand name plavix been safe and effective? Neurology. 2018;90:P5.239.

    Google Scholar 

  86. Povetkin SV, Luneva JV. Study of clinical efficacy of original and generic drugs of ivabradine in patients with stable angina (comparative study). Ration Pharmacother Cardiol. 2018;14:34–9.

    Google Scholar 

Download references

Acknowledgements

The authors would like to thank the librarians of the Institut national de santé publique du Québec for their help in developing the search strategy. CB has received a scholarship from the CHU de Quebec and the Fonds de recherche en santé du Québec. JMG has received a scholarship from the PAHO/WHO Collaborating Centre for Nursing Research Development and University of Sao Paolo.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jacinthe Leclerc.

Ethics declarations

Funding

The principal investigator (JL) has received academic research grants from the Ministère de l’Économie et de l’Innovation du Québec (Canada), the Canadian Heart Failure Society, the Quebec Heart Failure Society and the Université du Quebec à Trois-Rivières to conduct this study.

Conflict of interest

JS is a professor of medicine at McGill University and serves as the Chief Scientific Officer at JSS Medical Research, a contract research organisation that executes clinical trials/studies for pharmaceutical and biotechnology companies, as well as universities and hospitals. JL is a professor of nursing at Université du Québec à Trois-Rivières. Within her role of professor, she provides (1) Continuous Medical Education sessions for health care professionals, accredited by the Fédération des médecins omnipraticiens du Québec and its local affiliates and (2) statistical expertise on Data Safety Monitoring Board Committees managed by JSS Medical Research. Other authors have no conflict of interest to declare.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 2478 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leclerc, J., Thibault, M., Midiani Gonella, J. et al. Are Generic Drugs Used in Cardiology as Effective and Safe as their Brand-name Counterparts? A Systematic Review and Meta-analysis. Drugs 80, 697–710 (2020). https://doi.org/10.1007/s40265-020-01296-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40265-020-01296-x

Navigation