• The Baltimore Sun , Wednesday, June 18, 2008 9:46 AM

Large pharmaceutical companies are taking their fight against inexpensive generic drugs to the states, promoting proposals that would mean pharmacists could no longer automatically replace certain brand-name drugs with no-name counterparts. Measures have been considered by 27 states and approved by two -- Utah and Tennessee -- over the past year, according to the National Association of Chain Drug Stores, which opposes the changes.

The Food and Drug Administration has said repeatedly that generic drugs are safe and effective, and that brand-name drugs and their generic substitutes are equivalent and have the same effect on patients. But big drug companies say the common practice of substituting generics can cause harm. Even slight changes in formulation or manufacturing can cause side effects, they say.

The legislation being pushed at the state level would require pharmacists to inform doctors or get their permission before substituting a generic version of the drug. "For most patients, it isn't a problem, but for select patients it can be," says Laureen Cassidy, a spokeswoman for Abbott Laboratories.

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